Emer Jerome Gabao

Ermie Joy Suyamin

Jaizel Bernardino

Jenylene Marquez

Mary Jane Cunanan

TUBERCULOSIS

Definition.
Tuberculosis (abbreviated as TB for tubercle bacillus or Tuberculosis) is a common and often deadly infectious disease
caused by mycobacteria, mainly Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs (as pulmonary TB) but
can also affect the central nervous system, the lymphatic system, the circulatory system, the genitourinary system, the
gastrointestinal system, bones, joints, and even the skin.
Causes/Risk Factors
All cases of TB are passed from person to person via droplets. When someone with TB infection coughs, sneezes, or talks,
tiny droplets of saliva or mucus are expelled into the air, which could be inhaled by another person.
Risk factors for TB include the following:
○ HIV infection
○ Low socioeconomic status
○ Alcoholism
○ Homelessness
○ Crowded living conditions
○ Diseases that weaken the immune system
○ Migration from a country with a high number of cases
○ Health care workers
Signs and Symptoms
Respiratory symptoms may include horrible coughing that extends longer than three weeks, chest pains, blood or sputum
when coughing. Other symptoms include extreme fatigue, reduced weight, loss of appetite, high fever, chills, night sweats.
Medical Management
Treatment for TB uses antibiotics to kill the bacteria. The two antibiotics most commonly used are rifampicin and isoniazid.
However, instead of the short course of antibiotics typically used to cure other bacterial infections, TB requires much longer
periods of treatment (around 6 to 12 months) to entirely eliminate mycobacteria from the body.
However, treatment using Rifampicin and Pyrazinamide is not risk-free. The Centers for Disease Control and Prevention
(CDC) notified healthcare professionals of revised recommendations against the use of rifampin plus pyrazinamide for
treatment of latent tuberculosis infection, due to high rates of hospitalization and death from liver injury associated with the
combined use of these drugs.
Nursing Management
1. Maintain respiratory isolation until patient respond to treatment
2. Administer medicines as ordered
3. Check sputum always for blood or purulent expectoration
4. Encourage questions, conversation, to air their feelings
5. Teach or educate patient all about PTB
6. Encourage to stop smoking
7. Teach patient to cough or sneeze into to tissue paper and dispose secretions properly
8. Advise patients to have plenty of rest and eat balanced meals
9. Be alert on signs of drug reaction
10. Emphasize the importance of regular follow-up examination
Prevention
TB prevention and control takes two parallel approaches. In the first, people with TB and their contacts are identified and
then treated. Identification of infections often involves testing high-risk groups for TB. In the second approach, children are
vaccinated to protect them from TB. Unfortunately, no vaccine is available that provides reliable protection for adults.
However, in tropical areas where the levels of other species of mycobacteria are high, exposure to nontuberculous
mycobacteria gives some protection against TB.
LEPROSY

Definition
Leprosy (from the Greek lepi (λέπι), meaning scales on a fish), or Hansen's disease, is a chronic disease caused by the
bacteria Mycobacterium leprae and Mycobacterium lepromatosis. Leprosy is primarily a granulomatous disease of the
peripheral nerves and mucosa of the upper respiratory tract; skin lesions are the primary external symptom. Left untreated,
leprosy can be progressive, causing permanent damage to the skin, nerves, limbs and eyes.
Causes
Mycobacterium leprae and Mycobacterium lepromatosis are the causative agents of leprosy. M. lepromatosis is only the
causitive agent in diffuse lepromatous leprosy, which can be lethal
Signs and Symptoms

Signs and Symptoms:

Early: Late:
• Change in skin color • Loss of eyebrows
• Loss of sensation of skin lesion • Inability to close eyelids
• Decrease/loss of hair/sweat • Clawing of fingers and toes
• Thickened/painful nerves • Contractures
• Muscle weakness/paralysis of extremities
• Sinking of nosebridge
• Pain and redness of eyes
• Enlargement of the breast
• Nasal obstruction or bleeding
• Chronic ulcers
• Ulcers that do not heal
Medical Management
Until the development of dapsone, rifampicin, and clofazimine in the 1940s, there was no effective cure for leprosy.
However, dapsone is only weakly bactericidal against M. leprae and it was considered necessary for patients to take the drug
indefinitely. Moreover, when dapsone was used alone, the M. leprae population quickly evolved antibiotic resistance; by the
1960s, the world's only known anti-leprosy drug became virtually useless.
Multidrug therapy (MDT) and combining all three drugs was first recommended by a WHO Expert Committee in 1981.
These three anti-leprosy drugs are still used in the standard MDT regimens. None of them are used alone because of the risk
of developing resistance.
MDT remains highly effective and patients are no longer infectious after the first monthly dose. It is safe and easy to use
under field conditions due to its presentation in calendar blister packs.
Nursing Management
• Promote healthful living
• Help patient and family accept illness and treatment
• Provide mental and emotional support
• Referral of cases for management
Prevention
A single dose of rifampicin is able to reduce the rate of leprosy in contacts by 57% to 75%.
BCG is able to offer a variable amount of protection against leprosy as well as against tuberculosis.
SCHISTOSOMIASIS

Definition
Schistosomiasis (also known as bilharzia, bilharziosis or snail fever) is a parasitic disease caused by several species of fluke
of the genus Schistosoma.
Although it has a low mortality rate, schistosomiasis often is a chronic illness that can damage internal organs and, in
children, impair growth and cognitive development.
Causes
The mode of transmission is bathing, swimming, wading, or working in water contaminated with Schistosoma larvae. These
larvae penetrate the skin or mucous membranes and eventually work their way to the liver's venous portal circulation. There,
they mature in 1 to 3 months The adults then migrate to other parts of the body.
Signs and Symptoms
Initial signs and symptoms of schistosomiasis depend on the site of infection and the stage of the disease. Initially, a transient,
pruritic rash develops at the site of cercariae penetration, along with fever, myalgia, and cough. Later signs and symptoms
may include hepatomegaly, splenomegaly, and lymphadenopathy. Worm migration and egg deposition may cause such
complications as flaccid paralysis, seizures, and skin abscesses.
Medical Management
Schistosomiasis is readily treated using a single oral dose of the drug Praziquantel annually.[2] As with other major parasitic
diseases, there is ongoing and extensive research into developing a vaccine that will prevent the parasite from completing its
life cycle in humans.
Antimony has been used in the past to treat the disease. In low doses, this toxic metalloid bonds to sulfur atoms in enzymes
used by the parasite and kills it without harming the host. This treatment is not referred to in present-day peer-review
scholarship; Praziquantel is universally used. Outside of the US, there is a second drug available for treating Schistosoma
mansoni (exclusively) called Oxamniquine.
Nursing Management
• Regularly monitor and record the patient's temperature.
• Provide increased fluid and nutritional intake.
• When administering a prescribed antipyretic, minimize chills and diaphoresis by following a regular dosage
schedule.
• Promote patient comfort by maintaining a stable room temperature and providing frequent changes of bedding and
clothing.
• For high fevers, initiate treatment with a hypothermia blanket.
• Prepare the patient for laboratory tests, such as complete blood count and cultures of blood, urine, sputum, and
wound drainage.
Prevention
Methods of prevention of Schistosomiasis mentioned in various sources includes those listed below. This prevention
information is gathered from various sources, and may be inaccurate or incomplete. None of these methods guarantee
prevention of Schistosomiasis.
• Snail control
• Avoid contaminated water
• Avoid water contamined by sewage
FILARIASIS

Definition
Filariasis (Philariasis) is a parasitic and infectious tropical disease, that is caused by thread-like filarial nematode worms.
There are 9 known filarial nematodes which use humans as the definitive host. These are divided into 3 groups according to
the niche within the body that they occupy: Lymphatic Filariasis, Subcutaneous Filariasis, and Serous Cavity Filariasis.
Causes
Lymphatic Filariasis is caused by the worms Wuchereria bancrofti, Brugia malayi, and Brugia timori. These worms occupy
the lymphatic system, including the lymph nodes, and in chronic cases these worms lead to the disease Elephantiasis.
Subcutaneous Filariasis is caused by Loa loa (the African eye worm), Mansonella streptocerca, Onchocerca volvulus, and
Dracunculus medinensis (the guinea worm). These worms occupy the subcutaneous layer of our skin, our fat layer. Serous
Cavity Filariasis is caused by the worms Mansonella perstans and Mansonella ozzardi, which occupy the serous cavity of the
abdomen. In all cases, the transmitting vectors are either blood sucking insects (fly or mosquito) or Copepod crustaceans in
the case of Dracunculus medinensis.
Signs and Symptoms
The most spectacular symptom of lymphatic filariasis is elephantiasis—thickening of the skin and underlying tissues—which
was the first disease discovered to be transmitted by a mosquito bite. Elephantiasis results when the parasites lodge in the
lymphatic system.
Elephantiasis affects mainly the lower extremities, while the ears, mucus membranes, and amputation stumps are affected
less frequently. However, different species of filarial worms tend to effect different parts of the body: Wuchereria bancrofti
can affect the legs, arms, vulva, and breasts, while Brugia timori rarely affects the genitals. Interestingly, those who develop
the chronic stages of elephantiasis are usually amicrofilaraemic, and often have adverse immunlogical reactions to the
microfilaria as well as the adult worm.
Medical Management
The recommended treatment for killing adult filarial worms in patients outside the United States is albendazole (a broad
spectrum anthelmintic) combined with ivermectin. A combination of diethylcarbamazine (DEC) and albendazole is also
effective.
In 2003 the common antibiotic doxycycline was suggested for treating elephantiasis. Filarial parasites have symbiotic
bacteria in the genus Wolbachia, which live inside the worm. When the symbiotic bacteria are killed by the antibiotic, the
worms themselves also die. Clinical trials in June 2005 by the Liverpool School of Tropical Medicine reported that an 8 week
course almost completely eliminated microfilaraemia.
Nursing Management
• If the patient is uncomfortable, provide an antipyretic, tepid sponge bath, or a hypothermia blanket.
• Expect to obtain blood for routine blood work, platelet and white blood cell counts, liver and renal function studies,
erythrocyte sedimentation rate, and blood cultures.
• Prepare the patient for other diagnostic tests, such as chest X-ray, computed tomography, liver and spleen scan,
lymph node biopsy, or lymphography, to visualize the lymphatic system.
• If tests reveal infection, check your facility's policy regarding infection control and isolation precautions.
Prevention
Prevention includes giving entire communities medicine that kills the microscopic worms and controlling mosquitoes.
Avoiding mosquito bites is another form of prevention. The mosquitoes that carry the microscopic worms usually bite
between the hours of dusk and dawn. If you live in an area with lymphatic filariasis, you should:
• sleep under a mosquito net.
• use mosquito repellant on your exposed skin between dusk and dawn.
• take a yearly dose of medicine that kills the worms circulating in the blood. The medicine will kill all of the
microscopic worms in the blood and only a fraction of the adult worms.
MALARIA

Definition
Malaria is a vector-borne infectious disease caused by protozoan parasites. It is widespread in tropical and subtropical
regions, including parts of the Americas, Asia, and Africa. Each year, there are approximately 515 million cases of malaria,
killing between one and three million people, the majority of whom are young children in Sub-Saharan Africa.
Causes
Malaria is caused by protozoan parasites of the genus Plasmodium (phylum Apicomplexa). In humans malaria is caused by P.
falciparum, P. malariae, P. ovale, P. vivax and P. knowlesi. P. falciparum is the most common cause of infection and is
responsible for about 80% of all malaria cases, and is also responsible for about 90% of the deaths from malaria. Parasitic
Plasmodium species also infect birds, reptiles, monkeys, chimpanzees and rodents.
Signs and Symptoms
Symptoms of malaria include fever, shivering, arthralgia (joint pain), vomiting, anemia (caused by hemolysis),
hemoglobinuria, retinal damage, and convulsions.
Medical Management
There are several families of drugs used to treat malaria. Chloroquine is very cheap and, until recently, was very effective,
which made it the antimalarial drug of choice for many years in most parts of the world. However, resistance of Plasmodium
falciparum to chloroquine has spread recently from Asia to Africa, making the drug ineffective against the most dangerous
Plasmodium strain in many affected regions of the world. In those areas where chloroquine is still effective it remains the
first choice. Unfortunately, chloroquine-resistance is associated with reduced sensitivity to other drugs such as quinine and
amodiaquine.
Nursing Management
Good nursing care of the patient with severe malaria is of vital importance. Ensure meticulous nursing care. This can be life-
saving, especially for the unconscious patient. Maintain a clear airway. Nurse the patient in the lateral or semi-prone position
to avoid aspiration of fluid. Insert a nasogastric tube and suck out the stomach contents to minimize the risk of aspiration
pneumonia. Aspiration pneumonia is a potentially fatal complication that must be dealt with immediately (see inside back
cover flap). Turn the patient every 2 hours. Do not allow the patient to lie in a wet bed. Pay particular attention to pressure
points.
Keep a careful record of fluid intake and output. If this is not possible, weigh the patient daily in order to calculate the
approximate fluid balance.
Prevention
Speak with your physician or local travel clinic to receive up to date information about the best malaria protection for you.
Effectiveness of any given medication varies by the region of the world in which you plan to travel. Effectiveness also varies
from year to year, so current information is essential.
Prevention is based on:
• evaluating the risk of exposure to infection
• preventing mosquito bites by using mosquito repellant, bed nets, and clothing that covers most of the body
• chemoprophylaxis (preventive medications)
DENGUE

Definition
Dengue fever and dengue hemorrhagic fever (DHF) are acute febrile diseases, found in the tropics and Africa, and caused by
four closely related virus serotypes of the genus Flavivirus, family Flaviviridae.
Causes
Dengue fever can be caused by any one of four types of dengue virus: DEN-1, DEN-2, DEN-3, and DEN-4. Infection with
one virus does not protect a person against infection with another.
A person can be infected by at least two, if not all four types of the dengue virus at different times during a life span, but only
once by the same type.
Signs and Symptoms
This is manifested by a sudden onset of severe headache, muscle and joint pains (myalgias and arthralgias—severe pain gives
it the name break-bone fever or bonecrusher disease), fever, and rash. The dengue rash is characteristically bright red
petechiae and usually appears first on the lower limbs and the chest; in some patients, it spreads to cover most of the body.
There may also be gastritis with some combination of associated abdominal pain, nausea, vomiting, or diarrhea.
Medical Management
The mainstay of treatment is timely supportive therapy to tackle shock due to haemoconcentration and bleeding. Close
monitoring of vital signs in critical period (between day 2 to day 7 of fever) is vital. Increased oral fluid intake is
recommended to prevent dehydration. Supplementation with intravenous fluids may be necessary to prevent dehydration and
significant concentration of the blood if the patient is unable to maintain oral intake. A platelet transfusion is indicated in rare
cases if the platelet level drops significantly (below 20,000) or if there is significant bleeding.
Nursing Management
Proper nursing management of dengue fever requires collection of multiple blood draws; serial hematocrits until one to two
after fever resolution allow detection of hemoconcentration.
Prevention
• Turn pails and watering cans over and store them under shelter.
• Remove water in plant pot plates. Clean and scrub the plate thoroughly to remove mosquito eggs. Avoid the use of
plant pot plates, if possible.
• Loosen soil from potted plants to prevent the accumulation of stagnant water on the surface of the hardened soil.
• Do not block the flow of water in scupper drains along common corridors in HDB estates. Avoid placing potted
plants and other paraphernalia over the scupper drains.
• Cover rarely used gully traps. Replace the gully trap with non-perforated ones and install anti-mosquito valves.
• Cover bamboo pole holders after use. Rainwater can potentially accumulate in these bamboo pole holders if they are
uncovered and create a habitat.
• No tray or receptacles should be placed beneath and or/ on top of any air-conditioning unit so as not to create a
condition favourablefor mosquito breeding.
• Use insect repellant
CANCER

Definition
Cancer (medical term: malignant neoplasm) is a class of diseases in which a group of cells display uncontrolled growth
(division beyond the normal limits), invasion (intrusion on and destruction of adjacent tissues), and sometimes metastasis
(spread to other locations in the body via lymph or blood).
Causes
Cancer is a diverse class of diseases which differ widely in their causes and biology. The common thread in all known
cancers is the acquisition of abnormalities in the genetic material of the cancer cell and its progeny. Research into the
pathogenesis of cancer can be divided into three broad areas of focus. The first area of research focuses on the agents and
events which cause or facilitate genetic changes in cells destined to become cancer. Second, it is important to uncover the
precise nature of the genetic damage, and the genes which are affected by it. The third focus is on the consequences of those
genetic changes on the biology of the cell, both in generating the defining properties of a cancer cell, and in facilitating
additional genetic events, leading to further progression of the cancer.
Signs and Symptoms
• Local symptoms: unusual lumps or swelling (tumor), hemorrhage (bleeding), pain and/or ulceration. Compression of
surrounding tissues may cause symptoms such as jaundice (yellowing the eyes and skin).
• Symptoms of metastasis (spreading): enlarged lymph nodes, cough and hemoptysis, hepatomegaly (enlarged liver),
bone pain, fracture of affected bones and neurological symptoms. Although advanced cancer may cause pain, it is
often not the first symptom.
• Systemic symptoms: weight loss, poor appetite, fatigue and cachexia (wasting), excessive sweating (night sweats),
anemia and specific paraneoplastic phenomena, i.e. specific conditions that are due to an active cancer, such as
thrombosis or hormonal changes.
Medical/Surgical Management
Cancer can be treated by surgery, chemotherapy, radiation therapy, immunotherapy, monoclonal antibody therapy or other
methods. The choice of therapy depends upon the location and grade of the tumor and the stage of the disease, as well as the
general state of the patient (performance status). A number of experimental cancer treatments are also under development.
Complete removal of the cancer without damage to the rest of the body is the goal of treatment. Sometimes this can be
accomplished by surgery, but the propensity of cancers to invade adjacent tissue or to spread to distant sites by microscopic
metastasis often limits its effectiveness. The effectiveness of chemotherapy is often limited by toxicity to other tissues in the
body. Radiation can also cause damage to normal tissue.
Because "cancer" refers to a class of diseases, it is unlikely that there will ever be a single "cure for cancer" any more than
there will be a single treatment for all infectious diseases.
Nursing Management
• Help patient and family accept illness and treatment
• Palliative care solutions may include permanent or "respite" hospice nursing.
• Assist patient on every diagnostic tests or chemotherapy sessions
• If incurable, help patient prepare for a dignified death
Prevention
Cancer prevention is defined as active measures to decrease the incidence of cancer. This can be accomplished by avoiding
carcinogens or altering their metabolism, pursuing a lifestyle or diet that modifies cancer-causing factors and/or medical
intervention (chemoprevention, treatment of pre-malignant lesions). The epidemiological concept of "prevention" is usually
defined as either primary prevention, for people who have not been diagnosed with a particular disease, or secondary
prevention, aimed at reducing recurrence or complications of a previously diagnosed illness.
DIABETES MELLITUS

Definition
Diabetes mellitus often referred to simply as diabetes , is a syndrome of disordered metabolism, usually due to a combination
of hereditary and environmental causes, resulting in abnormally high blood sugar levels (hyperglycemia).
Causes
Type 1 diabetes: Type 1 diabetes is believed to be an autoimmune disease. The body's immune system attacks the cells in the
pancreas that produce insulin.
Type 2 diabetes: Type 2 diabetes has strong genetic links, meaning that type 2 diabetes tends to run in families. Several
genes have been identified and more are under study which may relate to the causes of type 2 diabetes. Risk factors for
developing type 2 diabetes include the following:
• High blood pressure
• High blood triglyceride (fat) levels
• Gestational diabetes or giving birth to a baby weighing more than 9 pounds
• High-fat diet
• High alcohol intake
• Sedentary lifestyle
• Obesity or being overweight
• Ethnicity, particularly when a close relative had type 2 diabetes or gestational diabetes: certain groups, such as
African Americans, Native Americans, Hispanic Americans, and Japanese Americans, have a greater risk of
developing type 2 diabetes than non-Hispanic whites.
• Aging: Increasing age is a significant risk factor for type 2 diabetes. Risk begins to rise significantly at about age 45
years, and rises considerably after age 65 years.
Signs and Symptoms
The classical triad of diabetes symptoms is polyuria, polydipsia and polyphagia, which are, respectively, frequent urination,
increased thirst and consequent increased fluid intake, and increased appetite. Symptoms may develop quite rapidly (weeks
or months) in type 1 diabetes, particularly in children. However, in type 2 diabetes symptoms usually develop much more
slowly and may be subtle or completely absent. Type 1 diabetes may also cause a rapid yet significant weight loss (despite
normal or even increased eating) and irreducible fatigue. All of these symptoms except weight loss can also manifest in type
2 diabetes in patients whose diabetes is poorly controlled.
Medical Management
Type 1 Diabetes
• Insulin must be given as an injection. If taken by mouth, insulin would be destroyed in the stomach before it could
get into the blood where it is needed.
• Most people with type 1 diabetes give these injections to themselves. Even if someone else usually gives the patient
injections, it is important that the patient knows how to do it in case the other person is unavailable.
• A trained professional will show the patient how to store and inject the insulin. Usually this is a nurse who works
with the healthcare provider or a diabetes educator.
• Insulin is usually given in two or three injections per day, generally around mealtimes. Dosage is individualized and
is tailored to the patient's specific needs by the healthcare provider. Longer acting insulins are typically administered
one or two times per day.
Type 2 Diabetes
• The best way to do this is to lose weight if obese and begin an exercise program.
• This will generally be tried for three to six months, then blood sugar and glycosylated hemoglobin will be
rechecked. If they remain high, the patient will be started on an oral medication, usually a sulfonylurea or biguanide
[metformin Glucophage)], to help control blood sugar level.
Nursing Management
Optometrists, podiatrists/chiropodists, dietitians, physiotherapists, nursing specialists (eg, DSNs (Diabetic Specialist Nurse)),
nurse practitioners, or Certified Diabetes Educators, may jointly provide multidisciplinary expertise. In countries where
patients must provide their own health care (i.e., in the developed world, the US, and in much of the undeveloped world), the
impact of out-of-pocket costs of adequate diabetic care can be very high. In addition to the medications and supplies needed,
patients are often advised to receive regular consultation from a physician (e.g., at least every three to six months).
Prevention
Type 1 diabetes risk is known to depend upon a genetic predisposition based on HLA types (particularly types DR3 and
DR4), an unknown environmental trigger (suspected to be an infection, although none has proven definitive in all cases), and
an uncontrolled autoimmune response that attacks the insulin producing beta cells. Some research has suggested that
breastfeeding decreased the risk in later life; various other nutritional risk factors are being studied, but no firm evidence has
been found. Giving children 2000 IU of Vitamin D during their first year of life is associated with reduced risk of type 1
diabetes, though the causal relationship is obscure.
ASTHMA

Definition
Asthma is a very common chronic disease involving the respiratory system in which the airways occasionally constrict,
become inflamed, and are lined with excessive amounts of mucus, often in response to one or more triggers.
Causes
Asthma is caused by a complex interaction of environmental and genetic factors that researchers do not yet fully understand.
These factors can also influence how severe a person’s asthma is and how well they respond to medication. As with other
complex diseases, many environmental and genetic factors have been suggested as causes of asthma, but not all of them have
been replicated. In addition, as researchers detangle the complex causes of asthma, it is becoming more evident that certain
environmental and genetic factors may affect asthma only when combined.
Signs and Symptoms
Asthma signs and symptoms include:
• Shortness of breath
• Chest tightness or pain
• Trouble sleeping caused by shortness of breath, coughing or wheezing
• An audible whistling or wheezing sound when exhaling
• Bouts of coughing or wheezing that are worsened by a respiratory virus such as a cold or the flu
Signs that asthma is probably getting worse include:
• An increase in the severity and frequency of asthma signs and symptoms
• A fall in peak flow rates as measured by a peak flow meter, a simple device used to check how well your lungs are
working
• An increased need to use bronchodilators — medications that open up airways by relaxing the surrounding muscles
Medical management
Long-term control medications
In most cases, these medications need to be taken every day. Types of long-term control medications include:
• Inhaled corticosteroids such as fluticasone (Flovent Diskus), budesonide (Pulmicort), triamcinolone (Azmacort),
flunisolide (Aerobid), beclomethasone (Qvar) and others. These medications reduce airway inflammation and are
the most commonly used long-term asthma medication. Unlike oral corticosteroids, these medications are
considered relatively low risk for long-term corticosteroid side effects. You may need to use these medications for
several days to weeks before they reach their maximum benefit.
• Long-acting beta-2 agonists (LABAs) such as salmeterol (Serevent Diskus) and formoterol (Foradil Aerolizer).
These inhaled medications, called long-acting bronchodilators, open the airways and reduce inflammation. They are
often used to treat persistent asthma in combination with inhaled corticosteroids. Long-acting bronchodilators
should not be used for quick relief of asthma symptoms.
• Leukotriene modifiers such as montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo CR). These
inhaled medications work by opening airways, reducing inflammation and decreasing mucus production.
• Cromolyn and nedocromil (Tilade). These inhaled medications reduce asthma signs and symptoms by decreasing
allergic reactions. They're considered a second choice to inhaled corticosteroids, and need to be taken three or four
times a day.
• Theophylline, a daily pill that opens your airways (bronchodilator). It relaxes the muscles around the airways.
Nursing Management
• Obtain history of recent medication use, particularly theophylline preparations, steroids and inhalers.
• Obtain baseline data on respiratory function, using spirometry or a peak flow meter, listen to breath sounds.
• Oxygen via prongs.
• Terbutaline may be used instead of epinephrine.
 • Assess vital signs every 15 to 30 minutes in initial treatment period; retake temperature at least once; observe for
changes in level of consciousness (e.g., depression due to hypoxemia or excitation due to aminophylline and/ or
epinephrine).
Prevention
Current treatment protocols recommend prevention medications such as an inhaled corticosteroid, which helps to suppress
inflammation and reduces the swelling of the lining of the airways, in anyone who has frequent (greater than twice a week)
need of relievers or who has severe symptoms. If symptoms persist, additional preventive drugs are added until the asthma is
controlled. With the proper use of prevention drugs, asthmatics can avoid the complications that result from overuse of relief
medications.
Asthmatics sometimes stop taking their preventive medication when they feel fine and have no problems breathing. This
often results in further attacks, and no long-term improvement.