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Bronchial asthama
The document provides a comprehensive overview of bronchial asthma, detailing its definition as a chronic inflammatory disorder of the airways characterized by obstruction and hyper-responsiveness to various stimuli. It discusses the etiology, clinical manifestations, diagnostic evaluation, management strategies, and potential complications associated with asthma. Emphasis is placed on the importance of identifying triggers, pharmacological and non-pharmacological treatments, and the need for careful monitoring during acute episodes.
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Bronchial asthama
- 1. BRONCHIAL ASTHMA SHYAM BHATEWARA LECTURER INDEXNURSING COLLEGE
- 2. Introduction Asthma is achronic lung disease that inflames & narrow the airways. Asthma is a reversible, obstructive airway disease in which trachea & bronchi respond in a hyperactive in certain stimuli.
- 3. Definition Chronic inflammatory disorderof the airways that causes varying degrees of obstruction in the airways Marked by airway inflammation and hyper responsiveness to a variety of stimuli or triggers Causes recurrent episodes of wheezing, breathlessness, chest tightness, and coughing associated with airflow obstruction that may resolve spontaneously
- 4. Etiological factors EnvironmentalFactors - Animal Cockroaches Dust Exhaust fumes Fireplaces Molds Perfumes or other products with aerosol sprays Pollen Smoke, including cigarette or cigar smoke Sudden weather changes
- 5. Physiological Factors Gastroesophagealreflux disease (GERD) Hormonal changes Sinusitis Stress Viral upper respiratory infection Genetic factor Hay fever & other allergies
- 6. Medications Acetylsalicylic acid (aspirin) β-Adrenergicblockers Nonsteroidal antiinflammatory drugs Occupational Exposure Factors Metal salts Wood and vegetable dusts Industrial chemicals and plastics
- 7. Pathophysiology Due toetiological factors Reversible and diffuse airway inflammation Hyper responsiveness of airway Airflow limitation Swelling of membrane line of airway Wheezing Cough Contraction bronchial muscle Dyspnea Chest tightness Bronchial enlargement & production of thick cough asthma
- 8. Types of asthma Allergic asthma – induced by hyper-immune response to allergens Non allergic asthma (intrinsic asthma) Mixed asthma- both allergic & non allergic Cough variant asthma- absence of classical symptoms, Only dry cough is present Exercise induced asthma Nocturnal asthma Occupational asthma
- 9. Clinical manifestation Restlessness Wheezing or crackles Absent or diminished lung sounds Hyper resonance Use of accessory muscles for breathing Tachypnea with hyperventilation
- 10. Clinical manifestation Prolonged exhalation Tachycardia Pulsusparadoxus Diaphoresis Cyanosis Decreased oxygen saturation
- 11. Diagnostic evaluation Detailedhistory collection Pulse oximetry Pulmonary Function Tests: Spirometry testing assesses the presence and degree of disease and can determine the response to treatment. Peak Expiratory Flow Rate Measurement: Measures maxi- mum flow of air that can be forcefully exhaled in 1 second; child uses a peak expiratory flowmeter to determine a “per- sonal best” value that can be used for comparison at other times, such as during and after an asthma attack.
- 12. Diagnostic evaluation BronchoprovocationTesting: Testing that is done to identify inhaled allergens; mucous membranes are directly exposed to suspected allergen in increasing amounts. Skin Testing: Done to identify specific allergens. Exercise Challenges: Exercise is used to identify the occurrence of exercise-induced bronchospasm. Radio allergosorbent Test: Blood test used to identify a specific allergen. Chest Radiograph: May show hyper expansion of the airways.
- 13. Managemnet Goal- Promote bronchodilationn Reduce inflammation Removesecretions Prevent ongoing symptoms Prevent asthma attack Maintain normal lung function Avoid triggers
- 14. Pharmacological therapy 1. Longterm control medication- Inhaled corticosteroid Leukotriene modifiers Long acting beta agonist Methylxanthines Combine inhaler
- 15. 2 Quick reliefmedication Short acting beta agonist Anticholinergic Oral or I/V corticosteroid 3 Bronchial thermoplasty- Form severe asthma that does not respond to medication
- 17. Non- pharmacological Oxygen therapy Posturaldrainage & chest physiotherapy Coughing & deep breathing exercise Avoidance of allergen relaxation technique acupuncture
- 18. Prevention Patients with recurrentasthma should undergo tests to identify the substances that precipitate the symptoms. Possible causes are dust, dust mites, roaches, certain types of cloth, pets, horses, detergents, soaps, certain foods, molds, and pol- lens. If the attacks are seasonal, pollens can be strongly sus- pected. Patients are instructed to avoid the causative agents whenever possible.
- 19. Complications Complications of asthmamay include status asthmaticus, respiratory failure, pneumonia, and atelectasis. Airway obstruction, particularly during acute asthmatic episodes, often results in hypoxemia, requiring the administration of oxygen and the monitoring of pulse oximetry and arterial blood gases. Fluids are administered, because people with asthma are frequently dehydrated from diaphoresis and in- sensible fluid loss with hyperventilation.
- 20. Nursing diagnosis Impairedgas exchange r/t altered oxygen supply Ineffective airway clearance r/t bronchospasm & obstruction from narrow lumen Ineffective breathing pattern r/t bronchospasm Risk for increasing attack of respiratory distress r/t exposure to allergens