Bronchial Asthma Diagnosis and Treatment

Bronchial asthma is the extra right title for the frequent form of asthma. Bronchial asthma is an illness brought on by increased responsiveness of the tracheobronchial tree to varied stimuli. The results paroxysmal constriction of the bronchial airways. Though the 2 kinds of bronchial asthma have related signs, together with wheezing (a whistling sound within the chest) and shortness of breath, they’ve fairly completely different causes.

The symptoms of bronchial asthma are tightness of chest, shortness for breath, coughing and wheezing. The causes are mainly hereditary. Allergies, eczema, and irritations that affect the bronchus cause the symptoms to manifest.

Allergic bronchial asthma is a kind of bronchial asthma that is triggered by allergens within the air. Allergens like: Cockroaches, Mud mites, Mould. Bronchial asthma attacks occur when one is exposed to these conditions that are not favorable to the bronchus. We have irritants found around ones working conditions such as strong scents may be through perfumes, colognes or even disinfectants that one inhales. It is therefore to be on the look out as to what triggers yours.

Bronchial Asthma Treatment 

Chest X-Ray: Your doctor might do a chest X-ray to rule out any other illnesses that may be inflicting related symptoms. Peak Expiratory Move (PEF): Utilizing a tool referred to as a peak movement meter, you forcefully exhale into the tube to measure the power of air you’ll be able to expend out of your lungs. Peak move monitoring can help you monitor your how well your asthma is doing at home. Spirometry: A lung perform check to measure your respiratory capacity and how properly you breathe. You’ll breathe into a device known as a spirometer.

Bronchial Asthma Treatment 

Bronchial asthma treatment now has new treatment protocols that recommend the prevention of asthma medications, such as inhaling corticosteroids or nebulizers. This medication usually helps an asthmatic person to suppress the inflammation of the lungs as well as reduce the swelling of the linings in the airway passages.

Another recommended asthma treatment is alternative therapies. A recent study shows that almost half of the population of asthmatic persons now uses the form of unconventional therapy for their bronchial asthma treatment.

Nursing Diagnosis for Asthma

Nursing Diagnosis for Asthma: Overview and Prognosis of Asthma

Overview of Asthma | Nursing Diagnosis for Asthma

Asthma is a disorder that causes the airways of the lungs to swell and narrow, leading to wheezing, shortness of breath, chest tightness, and coughing. (ncbi.nlm.nih.gov)

The airways become obstructed from either inflammation of the lining of the airways or constriction of the bronchial smooth muscles (bronchospasm). A known allergen, for example, pollen—is inhaled, causing activation of antibodies that recognize the allergen. Mast cells and histamine are activated, initiating a local inflammatory response. Prostaglandins enhance the effect of histamine. Leukotrienes also respond, enhancing the inflammatory response. White blood cells responding to the area release inflammatory mediators. A stimulus causes an inflammatory reaction, increasing the size of the bronchial linings; this results in restriction of the airways. There may be a bronchial smooth muscle reaction at the same time.

There are two kinds of asthma:

1. Extrinsic asthma, also known as atopic, caused by allergens such as pollen, animal dander, mold, or dust. Often accompanied by allergic rhinitis and eczema; this may run in families.








2. Intrinsic asthma, also known as non atopic, caused by a non allergic factor such as following a respiratory tract infection, exposure to cold air, changes in air humidity, or respiratory irritants.

Prognosis of Asthma | Nursing Diagnosis for Asthma

• Triggers for the asthmatic patient can often be identified and avoided. Patients can learn to check peak flow levels and manage symptoms in conjunction with their caregiver. Well controlled asthma typically has temporary, reversible exacerbations that can be controlled with medications, often in an outpatient setting. With frequent attacks, a mild exposure to a known trigger will often be sufficient to exacerbate an attack. Patients who do not respond to medications or who use medications improperly may die during an asthma attack.

Signs and Symptoms of Asthma| Nursing Diagnosis for Asthma

• Wheezing initially present on expiration continues throughout respiratory cycle as inflammation progresses. Air has difficulty moving through the narrowed airways, making noise. Not all asthmatics will have wheezing.








• Asymptomatic between asthma attacks. Symptoms resolve when there is no inflammation present.








• Difficulty breathing (dyspnea) as airways narrow due to inflammation. This is typically progressive as inflammation increases.








• Respiration greater than 20 breaths per minute (tachypnea) as the body attempts to get more oxygen into the lungs to meet physiologic needs.








• Use of accessory muscles to breathe as the body tries harder to get more air into the lungs.








• Tightness in the chest due to narrowing of the airways (bronchoconstriction).








• Cough.








• Tachycardia—heart rate greater than 100, as the body attempts to get more oxygen to the tissues.

Interpreting Test Result of Asthma| Nursing Diagnosis for Asthma

• Decreased oxygen and increased carbon dioxide present in arterial blood gas due to inability to move adequate air, which results in inadequate gas exchange.








• Decreased force on expiration [either forced expiratory volume in the first second (FEV1) or peak expiratory rate flow (PERF)] during attack shown in pulmonary function test. Narrowed airways make it more difficult for the patient to exhale, prolonging time of exhalation and decreasing force of exhalation. Patients can check expiratory effort at home on a peak flow meter.








• Hyperinflated lungs shown in chest x-ray due to air trapping.








• Pulse oximetry shows diminished oxygen saturation.








• CBC—elevated eosinophils.








• Sputum—positive for eosinophils.

Nursing Diagnosis for Asthma: Treatment of Asthma

Treatment of Asthma | Nursing Diagnosis for Asthma

• The focus of treatment is to return the respiratory status to normal, deliver adequate oxygen, and limit the number of recurrences. Patient education should focus on understanding the disease, its management, and when emergency care may be necessary.








• Administer supplemental oxygen to help meet body’s needs.








• Identify and remove allergens and known triggers to avoid causing an asthma attack.








• Give patient 3 liters/day of fluid to help liquefy any secretions.








• Administer short-acting beta2-adrenergic drugs to bronchodilate: albuterol, pirbuterol, metaproterenol, terbutaline, levalbuterol.








• Administer long-acting beta2-adrenergic drugs to manage symptoms day today; keep airways open, not for acute symptoms: salmeterol, formoterol.








• Administer leukotriene modulators to reduce local inflammatory response in lung to reduce exacerbations; does not have immediate effect on symptoms: zafirlukast, zileuton, montelukast.








• Administer anticholinergic drugs: ipratropium inhaler, tiotropium handihaler.








• Administer antacid, H2 blocker, or proton pump inhibitor to decrease the amount of acid in the stomach, reducing the possibility of ulcers due to stress of disease or medication effects.
  
  
  
  
  • Antacids: aluminum hydroxide/magnesium hydroxide, calcium carbonate
  
  

  
  

  
  
  • H2 blockers: ranitidine, famotidine, nizatidine, cimetidine
  
  

  
  

  
  
  • Proton pump inhibitors: omeprazole, lansoprazole, esomeprazole, rabeprazole, pantoprazole
  
  

  
  

  
  
  • Administer mast cell stabilizer (cromolyn, nedocromil) to retain an early component of the initial response to allergens, which will prevent further reactions from occurring; this is not for acute symptoms. This is useful for pretreatment for allergen exposure or chronic use to improve control of symptoms.
  
  

  
  

  
  
  • Administer steroids to decrease inflammation, which will help open airways; these are not for acute symptoms: hydrocortisone, methylprednisolone intravenously; beclomethasone, triamcinolone, fluticasone, budesonide, flunisolide, mometasone inhalers; prednisolone, prednisone orally
  
  

  
  

  
  
  • Administer methylxanthines to assist with bronchodilation, often used when other medications not effective: aminophylline, theophylline.
  
  
  
  

Nursing Diagnosis for Asthma and Nursing Interventions

Most Common Nursing Diagnosis for Asthma

• Impaired gas exchange








• Ineffective airway clearance








• Ineffective tissue perfusion

Nursing Interventions for Asthma

• Monitor respiration: patient’s respiratory status can continue to deteriorate; look at respiratory rate, effort, use of accessory muscles, skin color, breath sounds.








• Place patient in high Fowler’s position to ease respirations.








• Monitor vital signs, look for changes in BP, tachycardia, tachypnea.








• Explain to the patient:








• How to use a peak flow meter.








• How to use the metered dose inhaler or dry powder and in which order to take inhaled medication.








• Avoid exposure to allergen.








• How to recognize the early signs of asthma.








• How to perform coughing and deep-breathing exercises.

Other resources for nursing diagnosis for Asthma:

• www.cdc.gov

This is a sample of nursing diagnosis for Asthma.

Nursing Care Plans Diagnosis for Respiratory Disorders

Nursing Care Plans for Respiratory Disorders, The respiratory system provides vital gas exchange by distributing air to the alveoli. Here, pulmonary capillary blood takes on oxygen (O2) and gives off carbon dioxide (CO2). Other gases, such as carbon monoxide, diffuse from pulmonary capillary blood to the alveoli, where they’re excreted by the lungs.

Below is common Nursing care plans for Respiratory Disorders and it’s main NANDA nursing care plans diagnosis

Nursing care plans for Croup

Main NANDA nursing care plans diagnosis:

• Anxiety 

• Deficient knowledge 

• Disabled family coping

• Hyperthermia

• Impaired gas exchange

• Ineffective airway clearance

Nursing care plans for Epiglottiditis

Main NANDA nursing care plans diagnosis:

• Impaired gas exchange

• Impaired verbal communication

• Ineffective airway clearance

Nursing care plans for Respiratory distress syndrome (RDS)

Main NANDA nursing care plans diagnosis:

• Impaired gas exchange

• Impaired skin integrity

• Ineffective airway clearance

• Risk for infection  

• Risk for injury

Nursing care plans for Sudden infant death syndrome (SIDS)

Main NANDA nursing care plans diagnosis:

Dysfunctional grieving

Fear

Hopelessness

Interrupted family processes

Risk for sudden infant death syndrome

Spiritual distress

Nursing care plans for Acute respiratory distress syndrome (ARDS)

Main NANDA nursing care plans diagnosis:

Decreased cardiac output

Impaired gas exchange

Impaired physical mobility

Ineffective airway clearance

Ineffective tissue perfusion: Cardiopulmonary

Nursing care plans For Acute Respiratory Failure

Main NANDA nursing care plans diagnosis:

Disturbed thought processes

Impaired gas exchange

Impaired skin integrity

Ineffective airway clearance

Ineffective breathing pattern

Ineffective tissue perfusion: Cardiopulmonary

Nursing Care Plans For Atelectasis

Main NANDA nursing care plans diagnosis:

Impaired gas exchange

Ineffective airway clearance

Ineffective breathing pattern

Nursing Care Plans For Cor Pulmonale

Main NANDA nursing care plans diagnosis:

Activity intolerance  

Acute pain

Decreased cardiac output

Excess fluid volume

Impaired gas exchange

Ineffective airway clearance

Ineffective breathing pattern

Nursing Care Plans For Hemothorax

Main NANDA nursing care plans diagnosis:

Acute pain

Deficient fluid volume

Impaired gas exchange

Ineffective breathing pattern

Ineffective tissue perfusion: Cardiopulmonary

Nursing Care Plans For Pleural Effusion And Empyema

Main NANDA nursing care plans diagnosis:

Impaired gas exchange

Ineffective airway clearance

Ineffective breathing pattern

Nursing Care Plans for pleuritis/pleurisy

Main NANDA nursing care plans diagnosis:

Impaired gas exchange

Ineffective airway clearance

Ineffective breathing pattern

Nursing Care Plans for Pneumonia 

Main NANDA nursing care plans diagnosis:

Hyperthermia

Imbalanced nutrition: Less than body requirements

Impaired gas exchange

Ineffective airway clearance

Nursing Care Plans for Pneumothorax

Main NANDA nursing care plans diagnosis:

Impaired gas exchange

Ineffective breathing pattern

Ineffective tissue perfusion: Cardiopulmonary

Nursing Care Plans For Pulmonary Edema

Main NANDA nursing care plans diagnosis:

Excess fluid volume

Impaired gas exchange

Nursing Care Plans For Pulmonary Embolism

Main NANDA nursing care plans diagnosis:

Impaired gas exchange related to impaired pulmonary blood flow and alveolar collapse

Nursing Care Plans for Pulmonary Fibrosis

Main NANDA nursing care plans diagnosis:

Ineffective breathing pattern related to shortness of breath and difficulty breathing

Nursing Care Plans For Pulmonary Hypertension

Main NANDA nursing care plans diagnosis:

Activity intolerance

Decreased cardiac output

Impaired gas exchange

Nursing Care Plans for Asthma

Main NANDA nursing care plans diagnosis:

Ineffective airway clearance related to obstruction from narrowed lumen and thick mucus

Nursing Care Plans for Respiratory acidosis

Main NANDA nursing care plans diagnosis:

Decreased cardiac output

Impaired gas exchange

Ineffective airway clearance

Nursing Care Plans for Emphysema

Main NANDA nursing care plans diagnosis:

Impaired gas exchange related to destruction of alveolar walls

Nursing Care Plans for Laryngotracheobronchitis LTB(Croup)

Main NANDA nursing care plans diagnosis:

Ineffective airway clearance related to tracheobronchial infection and obstruction

Nursing Care Plans for Lung Cancer 

Main NANDA nursing care plans diagnosis:

Ineffective airway clearance related to obstruction caused by secretions or tumor

Nursing Care Plans for Tuberculosis (TB)

Main NANDA nursing care plans diagnosis:

Risk of infection related to tissue inflammation and infiltration caused by the TB bacilli