Asthma Overview and Risk Factors

Questions and Answers

What criteria indicate a positive response to a bronchodilator during pulmonary function tests?

An increase of more than 12% only

An increase of more than 200 mL and more than 12% (correct)

An increase of more than 200 mL only

No increase in volume or percentage

Which complication may NOT be revealed by a chest x-ray in patients with asthma?

Elevated serum IgE levels (correct)

Pneumothorax

Hyperinflation

Mucoid impaction

What is the role of the Niox Mino device in asthma management?

To measure arterial blood gases

To perform allergy skin testing

To assess serum eosinophil levels

To measure fractional exhaled nitric oxide (FENO) (correct)

What breathing technique should a patient use during nebulization treatment?

Slow, deep breaths with pauses Signup and view all the answers

Elevated serum eosinophil count and IgE levels are indicators of which condition?

Asthma Signup and view all the answers

Which blood gas abnormality is likely to occur early in an acute asthma attack?

Respiratory alkalosis Signup and view all the answers

After nebulization treatment, what is an important instruction for the patient?

To cough effectively to clear the airways Signup and view all the answers

Which of the following is NOT a diagnostic test for asthma?

Electrocardiogram (ECG) Signup and view all the answers

What is the main characteristic of asthma described as a chronic inflammatory disorder?

Recurrent episodes of wheezing, breathlessness, chest tightness, and cough Signup and view all the answers

During which phase of asthma response do symptoms primarily occur within 30 to 60 minutes after allergen exposure?

Early phase response Signup and view all the answers

Which of the following describes the late-phase response in asthma?

Occurs 4 to 6 hours after the early response with possible symptom recurrence Signup and view all the answers

What is a significant change seen in airway remodeling due to chronic asthma?

Structural changes in the bronchial wall leading to fibrous sub-epithelium Signup and view all the answers

Which of the following is NOT a physiological manifestation of severe asthma?

Severe wheezing across all spectra Signup and view all the answers

What role do pulmonary function tests serve in asthma diagnosis?

To determine the degree of airflow obstruction Signup and view all the answers

What does the early-phase response in asthma primarily involve?

Immediate bronchoconstriction after allergen exposure Signup and view all the answers

Which of the following factors is NOT considered a trigger for asthma?

Genetic predisposition Signup and view all the answers

Which symptom is most characteristic of cough variant asthma?

Non-productive cough as the only symptom Signup and view all the answers

What sign might indicate hypoxemia in a patient experiencing an asthma attack?

Restlessness and anxiety Signup and view all the answers

Study Notes

Overview of Asthma

Chronic inflammatory disorder of airways, leading to wheezing, breathlessness, chest tightness, and cough.
Symptoms often worsen at night or early morning.
Characterized by variable airflow obstruction, typically reversible either spontaneously or via treatment.

Risk Factors for Asthma

Genetics: Atopy refers to a genetic predisposition for allergic responses to common allergens.
Gender: Gender can influence the prevalence and severity of asthma.

Triggers of Asthma

Immune responses, respiratory tract infections (RTI), and allergens are major triggers.
Additional triggers include exercise, certain drugs and food additives, air pollutants, occupational factors, gastroesophageal reflux disease (GERD), and psychologic factors.

Asthma Response Phases

Early-Phase Response:
- Occurs within 30 to 60 minutes after allergen or irritant exposure.
Late-Phase Response:
- Symptoms may recur 4 to 6 hours after initial response due to an influx of inflammatory cells.
- Approximately 50% of individuals experience worsened symptoms, potentially lasting over 24 hours.

Airway Remodeling

Structural changes in bronchial walls due to chronic inflammation can lead to progressive loss of lung function.
Key changes include fibrosis, smooth muscle hypertrophy, mucus hypersecretion, persistent inflammation, and angiogenesis.

Clinical Manifestations

Common symptoms include wheezing (notable during exhalation), cough (especially at night), dyspnea (breathlessness), and chest tightness.
Increased work of breathing may lead to prolonged expiration (ratio of 1:3 or 1:4).
Patients may exhibit upright posture, use accessory respiratory muscles, and show signs of hypoxemia (e.g., anxiety, restlessness).

Severe Asthma Symptoms

Lack of audible wheezing in some cases, but inspiratory and expiratory wheezing can be present.
Difficulty speaking full sentences, respiratory rate exceeding 30 breaths/min, and hyperresonance may occur.
"Silent chest" indicates severely diminished or absent breath sounds, potentially leading to respiratory acidosis.

Cough Variant Asthma

Presents primarily with a non-productive cough, which may produce thick, tenacious mucus.

Diagnostic Tests for Asthma

Pulmonary Function Tests (PFTs):
- Assess reversibility of bronchoconstriction with bronchodilators, measuring peak expiratory flow rate (PEFR).
- Positive response defined as an increase of over 200 mL and more than 12% post-bronchodilator.
Chest X-ray:
- Can demonstrate hyperinflation and complications like mucoid impaction.
Allergy Skin Testing:
- Used to identify sensitivity to allergens.
Blood Studies:
- Elevated eosinophil count and serum IgE levels suggest atopy.
Oximetry and Nitric Oxide Measurement:
- Niox Mino assesses fractional exhaled nitric oxide (FENO) levels indicative of asthma status and treatment adherence.
Arterial Blood Gas:
- Early stages can show respiratory alkalosis, with potential progression to respiratory acidosis in severe cases.

Nursing Management in Asthma

Patient positioning: upright to enhance breathing efficiency.
Controlled breathing techniques: slow, deep breaths through the mouth, holding for 2-3 seconds.
Diaphragmatic breathing promotes effective medication delivery; ensure normal breathing between deep efforts.
Post-treatment: Encourage effective coughing to clear airways.

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Description

This quiz covers the fundamentals of asthma, a chronic inflammatory disorder of the airways. It includes important details about symptoms, risk factors such as genetics and gender, and the nature of airflow obstruction. Test your knowledge and understanding of this common respiratory condition.