Step3moderatepersistent daily symptoms u

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Unformatted text preview: ess, cough, hard to catch their breath u Results: AIRWAY OBSTRUCTION u Manifestations of Asthma Asthma l Triggers to Asthma u Genetics u Obesity u Allergens u Exercise u Air Pollutants u Nose and Sinus Problems u Psychologic Factors u Occupational Factors u Respiratory Infections u Drug & Food Additives u GERD Asthma Presentation u Presentation: – – – – – – – – – – – – Wheezing Breathlessness Chest Tightness Cough Tachypnea Use of accessory muscles Sitting upright Restlessness Anxiety Trouble speaking Decreased breath sounds Silent chest 4 Classifications of Asthma u Step 1­Mild Intermittent ­ no more than twice a week u Step 2­Mild Persistent ­ < QD but > twice a week u Step 3­ Moderate persistent ­ daily symptoms u Step 4­Severe Persistent ­continuous with frequent exacerbations & limit quality of life Complications of Asthma u Status Asthmaticus – – – **Life threatening asthma attack b/c unresponsive to common treatment Dyspnea at rest, speaks in words only, usually sitting forward, RR>30 bpm, HR >120 bpm, use of accessory muscles, agitation As it progresses, no wheezing is heard, bradycardia and impending respiratory failure Diagnosing Asthma u History & Physical examination u Peak Flow Variability or Spirometry u Pulmonary Function Tests(PFT’s) u Chest X Ray u u Nursing Care of Patients with Asthma Assessment Education – Avoid triggers – Avoid Aspirin, NSAIDS & Beta Blockers – Use of inhalers/nebulizers – Smoking Cessation u Apply O2 as prescribed u High Fowler’s Position = 40 degrees u Keep patient calm u Initiate/maintain IV access u Monitor FEFR daily at home­­­red/yellow/green zone u Drug Therapy Asthma Drug Therapy u Long Term Control Medications u Antiinflammatory Drugs – – Corticosteroids (PO or inhaled) Cromolyn (Intal) & Nedocromil ( Tilade) – Leukotriene modifiers – Omalizumab (Xolair) u Quick Relief Medications u Antiinflammatory Drugs – u Bronchodilators – u Bronchodilators – – Long­Acting Inhaled Beta 2­ adrenergic agonists Long­Acting oral Beta 2 adrenergic Corticosteroids (systemic) (3­ 10 days) Short­Acting inhaled Beta 2 adrenergic agonist (Albuterol) Anticholinergics (inhaled) (Atrovent) – Table 29­6 p 596 Drugs u Antiinflammatory – Corticosteroids—rinse mouth after use to decrease risk of oral candidiasis; ___________________are helpful to get more drugs to lungs u Fluticasone (Flovent) MDI, DPI u Budesonide (Pulmicort Turbuhaler) DPI – Leukotriene Modifiers­given orally only, used maintenance therapy, not acute asthma attacks u Montelukast (Singulair) – Anti­IgE u Omalizumab (Xolair) u Bronchodilators – Drugs Beta 2 Adrenergic Agonist u Long Acting­ should not be used as the 1st medicine to tx asthma, don’t use for sudden wheezing that is getting worse – – Salmeterol (Serevent) DPI Formoterol (Foradil) DPI u Short Acting—us...
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This document was uploaded on 03/05/2014 for the course NURS 301 at Liberty University Duplicate.

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