Issaiah Nicolle L.

Cecilia 3 BSN - A
RLE ACTIVITY 4
Outline the Pathophysiology in asthma. Stems with asterisks are primary processes. IgE, Immunoglobulin
E.

TRIGGERS *
Allergens
Exercise
Infection
Irritants

IgE-mast cell mediated response

Release of mediators from mast cells,

eosinophils, macrophages, lymphocytes

Early-phase response Late-phase response

Peaks in 30 to 60
minutes Peaks in 5 to 6
hours.
Bronchial smooth muscle constriction *
Mucosal edema
Mucus secretion Bronchial hyperreactivity
Vascular leakage Infiltration with eosinophils and
neutrophils
Inflammation*

Within 1 to 2
days

Infiltration with monocytes and

lymphocytes

Air trapping
Hypoxemia
Obstruction of large and small airways
Respiratory acidosis
 CLASSIFICATION OF ASTHMA SEVERITY
SEVERE PERSISTENT
 Symptoms are continuous.
 Physical activity requires limitations.
 Frequent exacerbation occur.
 Nocturnal symptoms occur frequently.
MODERATE PERSISTENT
 Daily symptoms occur.
 Daily use of inhaled short-acting β-agonist is needed. Exacerbations affect activity.
 Exacerbations occur at least twice weekly and may last for days.
 Nocturnal symptoms occur more frequently than once weekly.
MILD PERSISTENT
 Symptoms occur more frequently than twice weekly but less often than once daily.
 Exacerbations may affect activity.
 Nocturnal symptoms occur more frequently than twice a month.
MILD INTERMITTENT
 Symptoms occur twice weekly or less.
 Client is asymptomatic between exacerbations. Exacerbations are brief (hours to days).
 Intensity of exacerbations varies.
 Nocturnal symptoms occur twice a month or less.

Reference: Saunders Comprehensive Review for the NCLEX-RN Examination, 7 th Edition