Asthma Flashcards
(48 cards)
What is asthma ?
chronic inflammatory disorder of the airways resulting in reversible airflow obstruction and hyper-responsiveness of tracheobronchial tree to a variety of stimuli
What is the pathophysiology of asthma ?
- acute bronchoconstriction
- smooth muscle contraction
- airway edema
- mucosal thickening
- mucous secretion
- mucous plug formation
- airway remodeling: changes the respiratory system
What are some triggers for asthma ?
- strenuous exercise
- change in weather
- emotional stress
- infections
- allergen exposure
- inhaled irritants
- drugs and food adiitives
- gastroesophageal reflux
- nose and sinus problems
What are some clinical manifestations of asthma ?
- dry, non-productive cough
- SOB
- prolonged expiratory phase
- increased CO2 retention
- expiratory wheezing
- apprehension
- broken speaking
- hyperresonance on percussion of lungs
What are some S&S of hypoxia in pediatrics ?
- feeding difficulty
- inspiratory stridor
- nares flare
- expiratory grunting
- sternal retractions
What are some early and late signs of hypoxia ?
early
- restlessness
- anxiety
- tachycardia/tachypnea
late
- bradycardia
- extreme restlessness
- dyspnea (severe)
What causes chest retractions ?
intrapleural pressure becomes increasingly negative, the musculature “pulls back” in an effort to overcome the blockage
What do chest retractions indicate ?
an obstruction to inspiration at any point in the respiratory tract
- the degree and level of retraction depends on extent and level of obstruction
How is asthma classified into categories ?
- frequency and impact of symptoms
What is mild intermittent asthma ?
symptoms occur less than 2 times a week
- no limitation on activity
What is mild persistent asthma ?
symptoms occur more than twice a week but not daily
- minor limitation on activity
What is moderate persistent asthma ?
daily symptoms with exacerbations twice a week
- some limitations on activity
What is severe persistent asthma ?
symptoms occur continually and frequent daily exacerbations
- limits physical activity and quality of life
What does a yellow peak expiratory flow result mean ?
50-80%
- exacerbation possible or asthma not well managed
What does a red peak expiratory flow result mean ?
below 50%
- immediate bronchodilator needed
- contact health care provider
What is the diagnostic studies for asthma ?
- pulmonary function tests (PFTs)
- peak flow monitoring
- CXR: can show damage to lung tissues or any atelectasis
- O2 sat
- blood levels of eosinophils and IgE: increases with allergic reactions
How does asthma influence pulmonary function tests ?
decrease in forced vital capacity
- air trapping causes increase in functional residual volume
- prolonged I:E ration
- 1:3 or 1:4
- ABGs
What are some acute care interventions ?
- ongoing monitoring and assessments
- humidified O2
- hydration
- pt positioning
- quiet environment, rest, support
- medication
- patient and family teaching
How do B2 adrenergic agonists (bronchodilators) work ?
most effective drug for relieving bronchospasm
- suppress histamine release in the lungs
- act on beta 2 receptors to promote bronchodilation
How do corticosteroids work ?
- most effective anti-asthmatic drugs
- work by suppressing inflammation
- decrease bronchial hyperactivity
- usually inhaled, but can be IV or oral
How do mast cell stabilizers work ?
non-steroidal anti-inflammatory
- inhibit IgE mediated release of inflammatory mediator form mast cells
- suppress other inflammatory cells
- used for asthma prophylactically if allergen is causative agent
- takes several weeks before clinical response occurs
How do leukotriene modifiers work ?
- interfere with the synthesis or block the action of leukotrienes
- not for use in acute asthma
- used mainly for maintenance & prophylactic therapy
- effective for add on therapy to reduce not replaced inhaled corticosteroids
How do IgE antagonists work ?
- decreases circulating free IgE levels
- used for moderate to severe persistant asthma that cannot be controlled by with inhaled corticosteroids
- administered via SubQ injection q 2-4 weeks
How do mucolytics work ?
- react with mucus to make a watery consistency
- cough become more productive with use
- administered by inhalation
- can trigger bronchospasm
