Respiratory System: Asthma

AaLona Robinson Pediatrics Presentation June 20, 2012

Pathophysiology: Irritants to bronchial tree caused bronchial constriction resulting in narrowed and inflamed airways, dyspnea, and mucous production. All of which are reversible.

Asthma

TYPES: Allergic Non-Allergic (many clients experience mixed)

Asthma
Etiology
It is well recognized that, in the United States, asthma is more prevalent and more severe among black children than among white children. However, it is still unclear what is causing the rise in asthma, or what is responsible for the continuing racial disparities in its prevalence and severity. It appears that differences in asthma prevalence between population groups are due to differential exposure to environmental factors; genetic variation alone could not account for the rise in this diseases prevalence over a few decades. Hence, it may be that black race is merely a confounder for a set of exposures that disproportionately affect black children. In the United States, the inhabitants of impoverished inner-city areas are disproportionately black, and inner cities are the areas where asthma is worst. We hypothesize that urban residence is an independent risk factor for childhood asthma after controlling for race, poverty, and other environmental and demographic variables.

------ Risk Factors for Pediatric Asthma

Contributions of Poverty, Race, and Urban Residence C. ANDREW ALIGNE, PEGGY AUINGER, ROBERT S. BYRD, and MICHAEL WEITZMAN

Asthma
Signs and Symptoms *Shortness of Breath(Dyspnea) *Wheezing *Coughing *Production of Thick, Tenacious, Sputum *Use of Accessory Muscles *Every breath becomes an effort * Status Asthmaticus (life threatening) *Inability to speak in Full Sentences *Blue Lips *Persistent SOB *Agitation *Confusion

(Question 3)

Asthma
MEDICATIONS: Albuterol: Open up the bronchial tubes (air passages) of the lungs, they are used to treat the symptoms of asthma, and other lung diseases. Relieve cough, wheezing, SOB, and troubled breathing by increasing the flow of air the bronchial tubes. SE: restlessness, nervousness, tremors, dry mouth, and throat irritation (Question 5) Teaching: (Question 11) Albuterol Video

Beclomethasone Inhaler: Treats inflammation in the airway, causes dilation of the bronchioles.

Asthma
Hogan Thomas presents to the ER with signs of respiratory distress. Respirations are 42/min with wheezing. Hogan is a 12 year old that is excited about going to high school in the fall. His grandmother reports that he was helping her clean out the attic for money for summer camp when he began to have trouble breathing. He tried to use his fast acting inhaler but it did not help.

Asthma
ADPIE
Assessment: *Does Hogan have any allergies? *Does he exercise? *Does he/grandma have any pets? *Has this ever happened before? *What relieves symptoms? Diagnosis: Ineffective Breathing Pattern Ineffective Airway Clearance Anxiety
)

Asthma
Planning: *Patient maintains optimal breathing patter, AEB relaxed breathing, normal respiratory rate/pattern, and absence of dyspnea *Patient will be to demonstrate proper use of albuterol inhaler *Patient verbalizes knowledge of disease and its management

Asthma
Interventions: *Keep Hogan in High Fowlers position This position allows for adequate diaphragm excursion and lung expanasion. *Encourage the patient to cough. Especially after treatments. Teach effective coughing. Controlled coughing techniques help mobilize secretions from smaller airways to larger airways. *Encourage slow deep breathing. Instruct the patient to use pursed-lip breathing for exhalation. Instruct to time breathing so that exhalation takes 2 to 3 times as long as inspiration. Pursed lip breathing during exhalation produces a positive destedning pressure whitin the bronchioles, which facilites expiratiory airflow by helping to keep the bronchioles open. Prolong expiration prevents air trapping.

Asthma
References
Gulanick, M., & Myers, J. (2011). Nursing Care Plans (7th ed.). St. Louis: Elsevier Mosby. Timby, B., & Smith, N. (2010). Introductory to Medical Surgical Nursing (10th ed.). Philadelphia: Lippincott Williams & Wilkins.