1.

Objectives:

2. Introduction:

Bronchial asthma is a disease of the lungs in which an obstructive ventilation disturbance of the
respiratory passages evokes a feeling of shortness of breath. The cause is a sharply elevated
resistance to airflow in the airways. Despite its most strenuous efforts, the respiratory
musculature is unable to provide sufficient gas exchange. The result is a characteristic asthma
attack, with spasms of the bronchial musculature, edematous swelling of the bronchial wall and
increased mucus secretion. In the initial stage, the patient can be totally symptom-free for long
periods of time in the intervals between the attacks. As the disease progresses, increased mucus
is secreted between attacks as well, which in part builds up in the airways and can then lead to
secondary bacterial infection. Bronchial asthma is usually intrinsic (no cause can be
demonstrated), but is occasionally caused by a specific allergy (such as allergy to mold, dander,
dust). Although most individuals with asthma will have some positive allergy tests, the allergy is
not necessarily the cause of the asthma symptoms.

>Clinical Manifestations:
-Common symptoms of asthma in a steady-state include: nighttime coughing, shortness of
breath with exertion but no dyspnea at rest, a chronic 'throat-clearing' type cough, and complaints
of a tight feeling in the chest.

>Predisposing/Risk Factors:
-Tobacco smoke
-Infections such as colds, flu, or pneumonia
-Allergens such as food, pollen, mold, dust mites, and pet dander
-Exercise
-Air pollution and toxins
-Weather, especially extreme changes in temperature
-Drugs (such as aspirin, NSAID, and beta-blockers)
-Food additives (such as MSG)
-Emotional stress and anxiety
-Singing, laughing, or crying
-Smoking, perfumes, or sprays
-Acid reflux

>Etiology:
-The development of bronchial asthma is a multicausal process, which is caused by
exogenic factors (environmental factors), and also by genetic dispositions. In addition, the course
of the disease can be influenced by climatic changes and mental factors. Important exogenic
activators are: · Allergens o Environmental allergens (house dust mites, pollen) o Allergenic
work substances (flour) o Food allergens · Toxins or chemical irritants · Respiratory diseases ·
Pseudoallergic reactions (PAR) to analgesics (analgesic-induced asthma) · Physical exertion
(mainly in children) Patients with allergic asthma or other atopical diseases show a polygenic
inherited trait for an overshooting immune response of IgE. If both parents suffer from atopy, the
children have an atopical disease as well in 40-50% of the cases.
 >Diagnostic Procedures:
-Spirometry: A lung function test to measure your breathing capacity and how well you
breathe. You will breathe into a device called a spirometer.
-Peak Expiratory Flow (PEF): Using a device called a peak flow meter, you forcefully
exhale into the tube to measure the force of air you can expend out of your lungs. Peak flow
monitoring can allow you to monitor your how well your asthma is doing at home.
-Chest X-Ray: Your doctor may do a chest X-ray to rule out any other diseases that may be
causing similar symptoms.

3. NCP & Gordon’s

4. Drug study:

5. Anatomy and Physiology:

6. Pathophysiology:

7. Discharge Planning: