Asthma Overview and Risk Factors

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Questions and Answers

What is the primary characteristic of asthma?

Chronic inflammatory disease of the airways (correct)

Rapid weight loss during attacks

Permanent airway obstruction

Increased airflow in the lungs

Which of the following is NOT a common trigger for asthma symptoms?

Viral respiratory infections

Strong odors

Genetic predisposition (correct)

Air pollutants

During an asthma attack, which symptom is most likely to occur first?

Widened pulse pressure

Generalized wheezing (correct)

Central cyanosis

Tachycardia

Women are how much more likely than men to have asthma?

62% Signup and view all the answers

What physiological change contributes to airway obstruction in asthma?

Swelling of membranes lining the airways Signup and view all the answers

What is NOT considered a general risk factor for developing asthma?

Frequent exercise Signup and view all the answers

What chemical do mast cells release when activated during an asthma attack?

Histamine Signup and view all the answers

Which of the following symptoms is associated with severe asthma attacks?

Diaphoresis Signup and view all the answers

What characterizes mild intermittent asthma?

Symptoms less than 2 times a week with normal PEF Signup and view all the answers

What is a primary goal of asthma treatment?

Prevent chronic and troublesome symptoms Signup and view all the answers

Which type of medication is used for immediate treatment of asthma symptoms?

Quick-relief medications Signup and view all the answers

Which type of medication helps to reduce swelling and mucus production in the airways?

Corticosteroids Signup and view all the answers

What is one of the indications for using anticholinergics in asthma management?

To prevent muscle tightening around the airways Signup and view all the answers

In which scenario would a patient with mild asthma likely be treated?

Outpatient clinic successfully Signup and view all the answers

What type of medication is typically inhaled using a metered-dose inhaler for long-term control?

Long-acting medications Signup and view all the answers

What must be maintained to achieve optimal asthma care?

Normal activity levels and satisfaction with care Signup and view all the answers

What role does a nurse play in managing a patient with acute and severe asthma?

Provides emotional support and informs the patient about procedures. Signup and view all the answers

Which of the following is NOT considered a risk factor for death from asthma?

Regular use of rescue inhalers as prescribed. Signup and view all the answers

What key information should a patient with asthma understand for effective self-management?

The nature of asthma as a chronic inflammatory disease. Signup and view all the answers

What action should a nurse take if a patient with asthma requires intubation due to respiratory failure?

Assist with the intubation procedure and monitor the patient. Signup and view all the answers

How can patients effectively monitor their respiratory status at home?

By performing peak flow monitoring. Signup and view all the answers

In nursing management of an asthma patient, which aspect of care is most critical?

Assessing respiratory status and providing emotional support. Signup and view all the answers

What should a nurse assess before administering medications to an asthma patient?

A history of allergic reactions to medications. Signup and view all the answers

Which of the following medications should be used cautiously in patients with asthma?

Short-acting beta-adrenergic inhalers. Signup and view all the answers

Study Notes

Asthma

Affects 62% more women than men
A chronic inflammatory disease causing airway hyperresponsiveness, mucosal edema and mucus production
Leads to recurrent episodes of asthma symptoms: cough, chest tightness, wheezing, and dyspnea

Risk Factors

General factors:
- Female gender
- Exposure to indoor and outdoor allergens
- Occupational sensitizers
- Respiratory infections
- Air pollution
- Active/passive smoking
- Obesity

Pathophysiology

Characterized by reversible and diffuse airway inflammation
Inflammation leads to obstruction from:
- Swelling of the airways lining
- Bronchial smooth muscle contraction (bronchospasm)
- Increased mucus production
- Mast cells release chemicals (histamine and prostaglandins)

Common Triggers

Airway irritants:
- Air pollutants
- Cold
- Heat
- Weather changes
- Strong odors (perfumes, smoke)
Exercise
Stress or emotional upsets
Sinusitis with postnasal drip
Medications
Viral respiratory tract infections
Gastroesophageal reflux
Extreme emotions (crying, laughing, anger, fear, panic, stress, anxiety)
Drugs:
- Aspirin
- B-Adrenergic blockers
- Non-steroidal anti-inflammatory drugs

Clinical Manifestations

Asthma attacks often occur at night or early in the morning
Most common symptoms:
- Cough
- Dyspnea
- Wheezing
Generalized chest tightness
Generalized wheezing (first on expiration)
Diaphoresis (excessive abnormal sweating)
Tachycardia
Widened pulse pressure
Central cyanosis (late sign of poor oxygenation)

Classifications

Mild Intermittent: Symptoms less than 2 times per week, asymptomatic and normal PEF between exacerbations
Mild Persistent: Symptoms 2 times per week but less than daily, normal PEF between exacerbations
Moderate Persistent: Daily symptoms, PEF < 80% predicted, exacerbations affect activities
Severe Persistent: Frequent symptoms during the day and night, PEF < 60% predicted, frequent exacerbations

Medical Management: Goals

Prevent chronic and troublesome symptoms
Maintain near-normal pulmonary function
Maintain normal activity levels
Prevent recurrent exacerbations of asthma
Minimize the need for emergency department visits
Provide optimal pharmacotherapy with minimal adverse effects
Meet patients' and families' expectations and satisfaction with asthma care

Pharmacologic Therapy

Two general classes:
- Long-acting medications to achieve and maintain control of persistent asthma: corticosteroids, long-acting beta blockers
- Quick-relief medications for immediate treatment of asthma symptoms and exacerbations: short-acting beta-adrenergic agents

Types of Medications

Bronchodilators: relax muscles around airways
Anti-inflammatory medicines: reduce swelling and mucus production: corticosteroids
Combination medicines: inhaled bronchodilators and corticosteroids
Anticholinergics: prevent muscle bands from tightening around airways
Antibiotic or antiviral

Nursing Management

Assess respiratory status: severity of symptoms, breath sounds, peak flow, pulse oximetry, vital signs
Obtain history of allergic reactions to medications
Identify current use of medications
Administer medications as prescribed and monitor responses
Administer fluids for dehydration
Prescribe antibiotic agents for respiratory infections
Assist with intubation procedures if needed
Monitor patient closely
Inform patient and family about procedures

Home and Community-Based Care

Patient teaching:
- Nature of asthma as a chronic inflammatory disease
- Definition of inflammation and bronchoconstriction
- Purpose and action of each medication
- Triggers to avoid
- Proper inhalation technique
- How to perform peak flow monitoring

Death from Asthma: Risk Factors

Past history of sudden and severe exacerbations
Prior endotracheal intubation for asthma
Prior admission to the intensive care unit for an asthma exacerbation
Two or more hospitalizations for asthma within the past year
Three or more emergency care visits for asthma in the past year
Excessive use of short-acting beta-adrenergic inhalers (more than two canisters per month)
Recent withdrawal from systemic corticosteroids
Comorbidity of cardiovascular disease or COPD
Psychiatric disease
Low socioeconomic status

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Description

This quiz covers the fundamental aspects of asthma, including its prevalence, risk factors, and pathophysiology. Learn about the triggers that can exacerbate this chronic inflammatory disease and understand the physiological processes involved in asthma attacks. Perfect for students studying respiratory health or related fields.