ASTHMA 
Definition
Causes
References
Pharmacological management
Clinical manifestations
Pathophysiology
Nursing care plan
Condition in which the airways narrow, inflamed swell and produce extra mucous which causes difficulty in breathing
Wheezing when exhaling
Coughing or wheezing attacks that are worsened by a respiratory virus e.g. cold or flu
Chest tightness or pain
Shortness of breath
Sulfites and preservatives added to some types of foods and beverages
Strong emotions and stress
Certain medications, including beta blockers, aspirin and non-steroidal anti-inflammatory drugs e.g. ibuprofen, naproxen sodium
Air pollutants and irritants such as smoke
Physical activity
Genetic factors
Airborne allergens: pollen, dust mites, mold spores, pet dander or particles of cockroach waste
Cold air
Respiratory infections e.g. common colds
Gatroesophageal reflux disease whereby stomach acids build up into the throat
This leads to air trapping, increased dead space and hyperinflation
Allergic or extrinsic asthma is frequently associated with personal or family history of allergic diseases such as eczema, rhinitis and urticaria
Increased respiratory resistance and also bronchospasm, airway inflammation, mucosal edema and mucus plugging.
Normal serum levels of immunoglobulin E are commonly found in non-allergic asthma
Associated with increased responsiveness of the tracheobronchial tree from different stimuli
Characterized by inflammation of the airways with an abnormal accumulation of inflammatory cells in the bronchioles.
Mason R, Murray J. (2005). 'Murray and Nadel's Textbook of Respiratory Medicine, 4th Edition, Elsevier pp. 334
Maddox L, Schwartz D (2002)."The pathophysiology of asthma." pp 447
Use of anti-immunoglobulin E antibodies- omalizumab,
anti-IL4 /IL13 antibodies in selected patients
theophylline, leukotriene modifiers
Ipratropium
long acting bronchodilators such as beta-agonists and anticholinergics,
Use of control agents such as inhaled corticosteriods,
Assess respiratory rate, depth and rhythm
Assess for signs of dyspnea such as flaring of nostrils, chest retractions and use of accessory muscle
Assess patient's vital signs while in distress and report abnormalities
Assess for conversational dyspnea; it's a sign of respiratory distress
Monitor oxygen saturation and report abnormalities; normal levels are 95-100%
Monitor arterial blood gases (ABG)
Plan for period of rests between activities
Maintain head of patient's bed elevated