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28 Cards in this Set
- Front
- Back
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Asthma |
Chronic inflammatory disorder of the airways characterized by reoccurring symptoms such as airway obstruction, bronchial hyperresponsiveness, and underlying inflammatory process. |
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4 categories of asthma |
Based on symptoms Intermittent, mild, moderate, severe |
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Describe Intermittent asthma |
Symptoms <2day per week Night symptoms- None (0 to 4) <2 per month( 5 to 11yrs old) PEF- >80 NO interference with normal activity Use of short acting med for control <2 days per week |
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Describe moderate asthma |
Daily symptoms nighttime symptoms three to four times per month for ages 0 to 4 years, more than one week but not Knightly for ages 5 to 11 pef 60 to 80% of predicted value Some limitation with interference of normal activity use short-acting medication daily |
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Describe severe asthma |
Continual symptoms throughout the day Frequent nighttime symptoms Interferes with normal activity is Extreme Use a short-acting medication several times per day |
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Predisposing factors in children with asthma |
Atopy, or the genetic predisposition for the development of an immunoglobulin e ige, mediated response to Common Arrow allergens oh, it's the strongest identifiable predisposing factor for the development of asthma. Evidence also shows that Viral respiratory infections including RSV, may also have a significant role in the development and expression of asthma |
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Clinical manifestations of asthma |
*Cough that may be hacking, irritated, and non-productive. Becomes rattling and productive of frothy, clear, gelatinous sputum. *Shortness of breath ,prolonged expiratory phase ,audible wheeze, lips deep red in color ,possible progression to cyanosis, restlessness ,apprehension ,prominent sweating as attack progressives *. Chest hyperresonance on percussion ,course breath sounds wheezing and crackles. *With repeated episodes barrel chest, elevated shoulders, use of accessory muscles or respiration, facial appearance Latin mailer balls, circles beneath the eyes, narrow nose, prominent upper teeth |
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Classic manifestations of asthma 3 |
Dyspnea, wheezing, and coughing |
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Diagnostic test for asthma |
Primarily based on clinical manifestations, history and physical and to a lesser extent Laboratory test. * pulmonary function test * Peak expiratory flow rate *Bronchoprovocation testing * CBC, chest x-ray |
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Pulmonary function test |
Provide an objective method of evaluating the presence and degree of lung disease as well as the response to therapy. Spirometry can be used as well |
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Bronchoprovocation testing |
A direct exposure of the mucous membranes to a suspected antigen and increasing concentrations, helps identify inhaled allergens. Exposure to methacholine also known as The methacholine Challenge or cold or dry air may be performed to assess Airway responsiveness or reactivity |
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How is a CBC used in the diagnosis of asthma |
A CBC with diff can be performed to assess for the presence of a sign of Eosinophilia. Eosinphilia of greater than 500 suggest the presence of an allergic or inflammatory disorder |
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How is a chest x-ray used in the diagnosis of asthma |
They may be used to show frontal or lateral infiltrates and hyperexpansion of the Airways. May assist in ruling out a respiratory tract infection or other conditions |
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What are some ways that asthma can be controlled |
Allergen control, drug therapy, exercise, breathing exercises, hyposensitization |
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Allergen control |
Aimed at the prevention or reduction of exposure to Airborne allergens and irritants. |
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Corticosteroids |
Anti-inflammatory drugs used to treat reversible airflow obstruction, control symptoms, and reduce bronchial hyperresponsiveness and chronic asthma. Inhaled corticosteroids are used as first-line therapy and children older than 5 years old. May be given hi b, or early, or by inhalation |
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Corticosteroids used to treat asthma in children |
Budesonide and fluticasone |
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What should be monitored in children taking corticosteroids for asthma |
Besides responsiveness to medication primary care provider should monitor frequently the growth of Children and adolescents taking corticosteroids to assess the systemic effects of these drugs and to make appropriate reductions and doses are changes to other types of asthma therapy when necessary |
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2 classification of drugs used to treat asthma |
Long-acting in short-acting |
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Short-acting drugs used to control asthma |
B adrenergic Agonist such as albuterol, left Albuterol, and terbutaline |
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Mechanism of action for B adrenergic Agonist |
These drugs by with the B receptors on the smooth muscles of Airways, where they activate ADC AND CONVERT AMP TO CAMP . The increase Camp enhances binding of intercellular calcium reducing the availability of calcium dust allowing smooth muscle to relax. They also help stabilize mast cells to prevent release of mediators. |
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Salmeterol |
A long-acting bronchodilator used to treat asthma. It is usually used every 12 hours. It is not used for acute attacks |
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Exercise-induced bronchospasm |
And a cute, reversible, usually self-terminating Airway obstruction that develops during or after vigorous activity, reaches its peak 5 to 10 minutes after stopping the activity, and usually stops in another 20 to 30 minutes. Patients with eib have cough, shortness of breath, chest pain or tightness, wheezing oh, and endurance problems. |
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Status asthmaticus |
A continuous state of asthma symptoms and is considered a medical emergency that can result in respiratory failure and death if untreated. Children who continue to display respiratory distress despite vigorous therapeutic measures, especially the use of medications arebin CBC status asthmatics |
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Nursing alert for status asthmaticus |
A child with asthma who sweats profusely, remain sitting upright, and refuses to lie down it's in severe respiratory distress. Also, a child who suddenly becomes agitated or an agitated child who suddenly becomes quiet may have serious hypoxia and requires immediate intervention |
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Treatment for status asthmaticus |
*Humidify oxygen given to maintain oxygen saturation greater than 90% *Inhaled short-acting B2 Agonist are recommended *Three treatments of B2 Agonist spaced 20 to 30 minutes apart are usually given as an initial therapy, and continuous administration of B2 Agonist via nebulizer may be initiated. *A systematic corticosteroid and anticholinergic agent such as ipratropium bromide maybe added to the aerolized solution * B2 Agonist. An IV infusion is often initiated for hydration and to a give medications. * Correction of dehydration, acidosis, hypoxia, electrolyte balances is Guided by frequent determination of arterial pH, blood gases, and serum electrolytes * magnesium sulfate, a potent muscle relaxant may also be used in acute asthma attacks |
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Nursing interventions for asthma |
Monitor ABCs allow the child to assume a position of comfort administer humidified oxygen administered rescue medications as prescribed assess the patient's response to the rescue medications |
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Cystic fibrosis |
A Auto normal recessive disorder disease characterized by several clinical features which are a result an abnormal cftr Gene. |
