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Acute Asthma Exacerbation (Diagnosis (((Arterial blood gases (Huether &…
Acute Asthma Exacerbation
Epidemiology
Hospitalization rates highest in children and African Americans (Hammer & McPhee, 2019)
Risk factors
Smoking/Secondhand smoke exposure (Morris & Pearson, 2019)
Exercise (Morris & Pearson, 2019)
Urban living/air pollution (Morris & Pearson, 2019)
Indoor allergen exposure (Hammer & McPhee, 2019)
Cold, dry air exposure (Morris & Pearson, 2019)
Medication nonadherence (Morris & Pearson, 2019)
Mortality rate declining in U.S. (Hammer & McPhee, 2019)
Pathophysiology
Antigen exposure (Huether & McCance, 2017)
Adaptive immune response with activation of B-lymphocyes and eosinophils (Huether & McCance, 2017)
Mucosal edema (Huether & McCance, 2017)
Bronchospasm (Huether & McCance, 2017)
IgE production (Huether & McCance, 2017)
Increased mucus secretion (Huether & McCance, 2017)
Innate immune response from mast cell degeneration (Huether & McCance, 2017)
Clotting response (Huether & McCance, 2017)
Inflammatory response (Huether & McCance, 2017)
Clinical Presentation
Signs of respiratory failure
Hypercapnia/Respiratory Acidosis (Huether & McCance, 2017)
Diminished breath sounds/loss of expiratory wheezes (Huether & McCance, 2017)
Worsening hypoxemia (Huether & McCance, 2017)
Decreasing expiratory flow rate (Ortega & Genese, 2019)
Silent chest/no breath sounds (Huether & McCance, 2017)
Clinical Manifestations
Prolonged expiration (Ortega & Genese, 2019)
Tachypnea (Ortega & Genese, 2019)
Expiratory wheezes (Ortega & Genese, 2019)
Accessory muscle use/retractions/pursed lips (Ortega & Genese, 2019)
Chest tightness (Ortega & Genese, 2019)
Hypoxemia (Ortega & Genese, 2019)
Dyspnea/Shortness of breath (Ortega & Genese, 2019)
Pulsus paradoxus (Ortega & Genese, 2019)
Diagnosis
Arterial blood gases (Huether & McCance, 2017)
Respiratory alkalosis indicative of exacerbation (Huether & McCance, 2017)
Respiratory acidosis indicative of impending respiratory failure and need for mechanical ventilation (Huether & McCance, 2017)
Hypoxemia (Huether & McCance, 2017)
Pulse oximetry (Ortega & Genese, 2019)
Peak expiratory flow rate testing (Huether & McCance, 2017)
15-20% decrease from baseline indicative of exacerbation (Huether & McCance, 2017)
Clinical examination (Ortega & Genese, 2019)
Treatment
Corticosteroids (Huether & McCance, 2017)
Inhaled beta-agonist bronchodilators (Huether & McCance, 2017)
Mechanical ventilation with respiratory acidosis (Huether & McCance, 2017)
Oxygen therapy (Huether & McCance, 2017)