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ASTHMA

Chronic inflam­matory disorder of the airways resulting in interm­ittent and reversible airflow obstru­ction of the bronch­ioles

CONT­RIB­UTING FACTORS

Extr­ins­ic:
Intr­ins­ic:
Older adult clients:
Antige­n-a­ntibody reaction triggered by food, meds, or inhaled substances
Pathop­hys­iol­ogical abnorm­alities within the respir­atory tract
Beta receptors are less responsive to agonist and trigger bronch­ospasm

MANI­FES­TAT­IONS

Sudden, severe dyspnea w/ use of accessory muscles
Sitting up, leaning forward
Diapho­resis
Anxiety
Wheezing
Gasping
Coughing
Cyanosis (late sign)
Barrel chest

DIAG­NOSTIC PROCED­URES

ABGs
Sputum cultures
Pulmonary function tests
 

MEDI­CAT­IONS

BRON­CHO­DIL­ATO­RS:
Short-­acting inhaled: albuterol for rapid relief
Methyl­xan­thines: theoph­ylline
ANTI­-IN­FLA­MMA­TORY:
Cortic­ost­eroids: flutic­asone and prednisone
Leukot­riene antago­nists: montel­ukast
COMB­INATION AGENTS:
Ipratr­opium and albuterol
Flutic­asone and salmeterol
With inhaled agents, administer bronch­odi­lators BEFORE anti-i­nfl­amm­atory med

NURSING INTERV­ENT­IONS

Remain w/ pt during attack
Position pt in high-F­owler's
Monitor lung sounds & pulse oximetry
Administer oxygen therapy
Maintain IV access
Therap­eutic measures: respir­atory treatm­ents, oxygen admini­str­ation

CLIENT EDUCAT­ION

Avoid allergens & triggers
Properly use inhaler and peak flow monitoring

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