Question

1. What factors may trigger an asthmatic episode? What are the clinical manifestations of a child experiencing an exacerbation of asthma? 2. 3. Explain the progression of asthma that is nonressponsive to treatment. Discuss the pathophysiology of asthma. 4. 5. Discuss the actions, side effects, contraindications, and nursing implications of the following medications in the treatment of asthma: albuterol, atrovent, epinephrine, prednisolone prednisone, solumedrol, magnesium sulfate, sodium bicarbonate. 6. Discuss the following treatment modalities for the treatment of asthma and note when each is indicated: aerosolized medications by nebulizer, metered-dose inhaler, oxygen, heliox therapy, BiPap. 7. Discuss consent for treatment of a minor. How does the nurse proceed if the parent is unreachable?

Answer 1

Ans) 1) An asthma attack can be triggered by exposure to an allergen, such as tree, grass or weed pollen, dust mites, cockroaches or animal dander. Other common triggers are irritants in the air, such as smoke or chemical fumes, and strong odors, such as perfume.

2) Cough: can be chronic, can occur at night, dry, during exercise, mild, severe, or with phlegm
Respiratory: breathing through the mouth, difficulty breathing, fast breathing, frequent respiratory infections, rapid breathing, shortness of breath at night, or wheezing
Also common: anxiety, chest pressure, early awakening, fast heart rate, flare, or throat irritation.

Common childhood asthma signs and symptoms include: Frequent coughing that worsens when your child has a viral infection, occurs while your child is asleep or is triggered by exercise or cold air. A whistling or wheezing sound when breathing out. Shortness of breath.

3) The approach to and management of severe asthma is a complex process best implemented in specialized centres. Fortunately, although rates of morbidity and utilization of health care services are high, the number of people with very severe or difficult-to-treat asthma in Canada is relatively small. Currently, omalizumab seems to be a safe, well-tolerated addition to the armamentarium for suitable, carefully selected patients with severe, atopic asthma.

4) Pathophysiology of Asthma:

) Exposure to trigger factor
2) Activation of mast cells and eosinophils (also other cells involved in inflammation and immunity)
3) Release of mediators
4) Symptoms of asthma
a) Mucus hypersecretion
b) Vasodilation and plasma leak, causing pulmonary oedema
c) Bronchoconstriction via cholinergic reflex stimulating contraction of airway smooth muscle.