Asthma

What respiratory illness is chronic with insidious or ACUTE onset, characterized by inflammation of the bronchioles?

• Asthma

• RSV

• COPD

• Emphysema

S/S of asthma includes:

• • Dyspnea or shortness of breath

  • Chest tightness

  • Retraction when inhaling

  • Wheezing upon exhale

• • Chest tightness

• • Retraction when inhaling

• • Wheezing upon exhale

• Prolonged exhalation

Besides from the common triggers of asthma (dust, extreme cold, heat, exercise, ALLERGIES) what other factors can trigger an asthma flare up? This one surprised me. Select all that apply

• NSAIDS

• aspirin

• Beta Blockers-was a question on the pharm exam.

• cholinergic

• Theophylline

Answer explanation

Theophylline is used as a treatment for asthma. Just know that Beta blockers in the older population can cause spasms of the bronchioles due to the beta adrenic receptors losing sensitivity with age. Other words-just do not give beta blockers to asthmatics.

severe, prolonged asthma that is difficult to treat

• status asthmaticus

• severe asthmaticus

• difficult asthmaticus

• resistant asthmatics

(true/false)Although having a barrel chest is a key sign for COPD, barrel chest is also a S/S of asthma.

ABG lab values of a person experiencing an asthma attack: EARLY Stages includes which of the following descriptions? Select all that apply

• Decreased PaO2 less than 80

• Increased PaO2 more than 80

• Decreased PaCO2 less than 35

• Increased PaCO2 more than 45

Answer explanation

Respiratory ALKALOSIS is common at the early stages of an asthma attack due to hyperventilation.

Late Stage: Respiratory ACIDOSIS due to the inflammation not allowing CO2 to be exerted from the body (Hypoventilation). Lab Values would look like: Low PaO2 of less than 80. HIGH PH of more than 7.45; LOW PaCO2 of less than 35 (HypoCARBIA)

ABG lab values for a person suffering symptoms of long term asthmatic symptoms, especially tightness of chest and dyspnea would look like:

• Increased PaCO2 of 45+

• Decreased PaCO2 of less than 35.

• Increased PaO2 of more than 80.

• Decreased PaO2 of less than 80

Answer explanation

HyperCARBIA

Due to HYPOventilation: the pt in the late stages of the attack would have low PH of less than 7.35 and PACO2 of greater than 45.

Most common and accurate tests for diagnosing Asthma?

• Viral Panel

• Lung biopsy

• MRI

• Pulmonary Functioning Tests (PFTs)

Answer explanation

A decrease in FEV1 by 15-20% below the expected value is common in ppl who have asthma. An increase in these values by 12% following the administration of bronchodilators is diagnostic for asthma.

** X ray is also used sometimes to look at the structural changes of the lungs.

Nursing Interventions:

Certain medications can treat bronchial inflammation and improve oxygen and carbon dioxide gas exchange in the bloodstream. THese medications that are used for the treatment of Asthma includes: Select all that apply

• • Daily corticosteroids

• • Anti-inflammatory anticholinergics

• • Theophylline

• • Short-acting beta 2-agonist, Albuterol

What Medication that s used in the first line of defense during an asthma attach is?

• Steroid

• Oxygen

• Theophylline

• • Short-acting beta 2-agonist, Albuterol

Answer explanation

You would apply oxygen during a severe asthma attack as well. However, a SABA must be administered first. Oxygen therapy for severe asthma attacks supplies a person with additional oxygen. There are various oxygen therapy devices a doctor can use to treat an asthma attack. Oxygen therapy can also treat other conditions that cause low oxygen levels. Oxygen therapy is generally safe.