GROUP 7

ASTHMA
 INTRODUCTION
Asthma is a common long-term condition that affects the lungs,
causing the airways to become inflamed and narrow. This makes it
hard to breathe and leads to symptoms like wheezing, shortness of
breath, chest tightness, and coughing. These symptoms can be
triggered by allergens (such as pollen), exercise, cold air, and
respiratory infections.
Managing asthma well is crucial to prevent severe attacks, reduce
symptoms, and improve quality of life. This case study looks at how
to manage asthma effectively. We will discuss how asthma is
diagnosed, the typical treatments used, and lifestyle changes that
can help. By understanding these aspects, people with asthma can
better control their condition and live healthier lives.
 ASTHMA?
WHAT IS
Asthma is a chronic inflammatory disease
of the airways that causes airway
hyperresponsiveness, mucosal edema, and
mucus production.
Inflammation ultimately leads to recurrent
episodes of asthma symptoms.
Patients with asthma may experience
symptom-free periods alternating with
acute exacerbations that last from minutes
to hours or days.
Asthma, the most common chronic disease
of childhood, can begin at any age.
 STATI STI CS AN D
EPIDEM IO LO GY

Asthma affects Asthma accounts The total

more than 90 for more than economic cost
497, 000 of asthma
million people in
hospitalizations exceeds $27.6
the Philippine
annually billion.
population.
 CAUSES

Allergy is the strongest predisposing

factor for asthma.
Chronic exposure to airway irritants.
Irritants can be seasonal (grass, tree,
and weed pollens) or perennial (mold,
dust, roaches, animal dander).
Exercise. Too much exercise can also
cause asthma.
Stress/ Emotional upset. This can trigger
constriction of the airway leading to
asthma.
Medications. Certain medications can
trigger asthma.
 CLINICAL MANIFESTATIONS
Most common symptoms of asthma are cough (with or without
mucus production), dyspnea, and wheezing (first on expiration,
then possibly during inspiration as well).

Cough. There are Dyspnea. General

instances that cough is tightness may occur
the only symptom. which leads to dyspnea.

Wheezing. There may be

wheezing, first on expiration,
and then possibly during
inspiration as well.
Asthma attacks frequently
occur at night or in the early
morning.
An asthma exacerbation is
frequently preceded by
increasing symptoms over days,
but it may begin abruptly.
Expiration requires effort and
becomes prolonged.
As exacerbation progresses,
central cyanosis secondary to
severe hypoxia may occur.
Additional symptoms, such as
diaphoresis, tachycardia, and a
widened pulse pressure, may occur.
Exercise-induced asthma: maximal
symptoms during exercise, absence of
nocturnal symptoms, and sometimes
only a description of a “choking”
sensation during exercise.
A severe, continuous reaction, status
asthmaticus, may occur. It is life-
threatening.
Eczema, rashes, and temporary edema
are allergic reactions that may be
noted with asthma.
 ASSESSMENT AND
DIAGNOSTIC FINDINGS
To determine the diagnosis of asthma, the clinician must determine
that episodic symptoms of airway obstruction are present.
Positive family history. Asthma is a hereditary disease, and can be
possibly acquired by any member of the family who has asthma
within their clan.
Environmental factors. Seasonal changes, high pollen counts, mold,
pet dander, climate changes, and air pollution are primarily
associated with asthma.
Comorbid conditions. Comorbid conditions that may accompany
asthma may include gastroeasophageal reflux, drug-induced
asthma, and allergic broncopulmonary aspergillosis.
 MEDICAL MANAGEMENT

Most asthma medications that work for adults and older children
can also be safely prescribed to toddlers and younger children.
Drugs that are approved for younger children are given in doses
adjusted for their age and weight. In the case of inhaled drugs,
they may need a different delivery
.
device based on their age and
ability

There are two main types of asthma medications:

•Quick-relief medications
•Long-acting medications
 MEDICAL MANAGEMENT
Quick-relief medicines quickly open swollen airways. Also called
rescue medicines, quick-relief medicines are used as needed for
rapid, short-term symptom relief during an asthma attack — or
before exercise if your child's health care provider recommends
it.Types of quick-relief medicines include:
•Short-acting beta agonists: These inhaled bronchodilator
medicines can rapidly ease symptoms during an asthma attack.
They include albuterol and levalbuterol (Xopenex HFA)
•Oral and intravenous corticosteroids: These medicines relieve
airway inflammation caused by severe asthma. Examples include
prednisone and methylprednisolone
 MEDICAL MANAGEMENT

•Treatment for allergy-induced asthma

Omalizumab: It reduces the immune system's reaction to allergy-
causing substances, such as pollen, dust mites and pet dander.
Omalizumab is delivered by injection every 2 to 4 weeks.

Allergy medicines: These include oral and nasal spray

antihistamines and decongestants as well as
corticosteroid, cromolyn and ipratropium nasal sprays.

Allergy shots, also called immunotherapy: Over time, they gradually

reduce your child's immune system reaction to specific allergens.
 MEDICAL MANAGEMENT
Long-term control medicines

Long-acting medications prevent airway inflammation and keep

asthma under control. Types of long-term control medicines
include:

•Inhaled corticosteroids. These medicines include fluticasone

(Flovent Diskus), budesonide (Pulmicort Flexhaler), mometasone
(Asmanex HFA), ciclesonide (Alvesco), beclomethasone (Qvar
Redihaler) and other
 MEDICAL MANAGEMENT

•Leukotriene modifiers: These oral medicines include montelukast

(Singulair), zafirlukast (Accolate) and zileuton (Zyflo). They help
prevent asthma symptoms for up to 24 hours.

•Combination inhalers: These medicines contain an inhaled

corticosteroid plus a long-acting beta agonist (LABA). They include
fluticasone and salmeterol (Advair Diskus), budesonide and
formoterol (Symbicort), fluticasone and vilanterol (Breo Ellipta), and
mometasone and formoterol (Dulera).
 MEDICAL MANAGEMENT

•Theophylline (Theo-24): This is a daily pill that helps keep the airways
open. Theophylline relaxes the muscles around the airways to make
breathing easier. It's mostly used with inhaled steroids.

I•Immunomodulatory agents: Mepolizumab (Nucala), dupilumab

(Dupixent) and benralizumab (Fasenra) might be appropriate for
children over the age of 12 who have severe eosinophilic asthma.
 MEDICAL MANAGEMENT
Inhaled medicine devices
Inhaled short- and long-term control medicines are used by inhaling
a measured dose of medicine.
•Older children and teens might use a small, hand-held device called a
pressurized metered dose inhaler or an inhaler that releases a fine
powder.
•Infants and toddlers need to use a face mask attached to a
metered dose inhaler or a nebulizer to get the correct amount of
medicine.
•Babies need to use a device that turns liquid medication into fine
droplets, called a nebulizer. Baby wears a face mask and breathes
regularly while the nebulizer delivers the correct dose of medicine
 PHARMACOLOGICAL
MANAGMENT
Short-acting beta2 –adrenergic agonists. These are the medications
of choice for relief of acute symptoms and prevention of exercise-
induced asthma.
Anticholinergics. Anticholinergics inhibit muscarinic cholinergic
receptors and reduce intrinsic vagal tone of the airway.
Corticosteroids. Corticosteroids are most effective in alleviating
symptoms, improving airway function, and decreasing peak flow
variability.
Leukotriene modifiers. Anti Leukotrienes are potent
bronchoconstrictors that also dilate blood vessels and alter
permeability.
Immunomodulators. Prevent binding of IgE to the high affinity
receptors of basophils and mast cells.
 NURSING MANAGEMENT

Assess history. Obtain a history of allergic reactions to

medications before administering medications.
Assess respiratory status. Assess the patient’s
respiratory status by monitoring the severity of symptoms,
breath sounds, peak flow, pulse oximetry, and vital signs.
Assess medications. Identify medications that the patient
is currently taking. Administer medications as prescribed
and monitor the patient’s responses to those medications;
medications may include an antibiotic if the patient has an
underlying respiratory infection.
Pharmacologic therapy. Administer medications as
prescribed and monitor patient’s responses to medications.
Fluid therapy. Administer fluids if the patient is dehydrated.
 NURSING ASSESSMENT

Assessment of a patient with asthma

includes the following:
Assess the patient’s respiratory
status by monitoring the severity of
the symptoms.
Assess for breath sounds.
Assess the patient’s peak flow.
Assess the level of oxygen saturation
through the pulse oximeter.
Monitor the patient’s vital signs
 NURSING DIAGNOSIS

Ineffective airway clearance

related to increased
production of mucus and
bronchospasm.
Impaired gas exchange
related to altered delivery of
inspired O2.
Anxiety related to perceived
threat of death.
 GROUP 7

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