nursing paper on asthma

Learn about the nursing care management of patients with asthma in this nursing study guide .

Table of Contents

• What is Asthma? 

Pathophysiology

• Statistics and Epidemiology

Clinical Manifestations

Complications, assessment and diagnostic findings, pharmacologic therapy, peak flow monitoring, nursing assessment, nursing diagnosis, nursing care planning & goals, nursing interventions, discharge and home care guidelines, documentation guidelines, what is asthma.

Asthma affects people in their different stages in life, yet it can be avoided and treated.

• Asthma is a chronic inflammatory disease of the airways that causes airway hyperresponsiveness, mucosal edema , and mucus production.
• Inflammation ultimately leads to recurrent episodes of asthma symptoms.
• Patients with asthma may experience symptom-free periods alternating with acute exacerbations that last from minutes to hours or days.
• Asthma, the most common chronic disease of childhood, can begin at any age.

The underlying pathophysiology in asthma is reversible and diffuse airway inflammation that leads to airway narrowing.

• Activation. When the mast cells are activated, it releases several chemicals called mediators.
• Perpetuation. These chemicals perpetuate the inflammatory response, causing increased blood flow, vasoconstriction,, fluid leak from the vasculature, the attraction of white blood cells to the area, and bronchoconstriction.
• Bronchoconstriction. Acute bronchoconstriction due to allergens results from a release of mediators from mast cells that directly contract the airway.
• Progression. As asthma becomes more persistent, the inflammation progresses and other factors may be involved in the airflow limitation.

Statistics and Epidemiology

Asthma is considered the most common chronic disease of childhood and is a disruptive disease that affects school and work attendance.

• Asthma affects more than 22 million people in the United States.
• Asthma accounts for more than 497, 000 hospitalizations annually.
• The total economic cost of asthma exceeds $27.6 billion.

Despite increased knowledge on the pathology of asthma and the development of improved medications and management plans, the death rate from the disease continues to rise. Here are some of the factors that influence the development of asthma.

• Allergy . Allergy is the strongest predisposing factor for asthma.
• Chronic exposure to airway irritants. Irritants can be seasonal (grass, tree, and weed pollens) or perennial (mold, dust, roaches, animal dander).
• Exercise. Too much exercise can also cause asthma.
• Stress/ Emotional upset. This can trigger constriction of the airway leading to asthma.
• Medications. Certain medications can trigger asthma.

The signs and symptoms of asthma can be easily identified, so once the following symptoms are observed, a visit to the physician is necessary.

• Most common symptoms of asthma are cough (with or without mucus production), dyspnea , and wheezing (first on  expiration , then possibly during inspiration as well).
• Cough . There are instances that cough is the only symptom.
• Dyspnea. General tightness may occur which leads to dyspnea .
• Wheezing. There may be wheezing, first on expiration, and then possibly during inspiration as well.
• Asthma attacks frequently occur at night or in the early morning.
• An asthma exacerbation is frequently preceded by increasing symptoms over days, but it may begin abruptly.
• Expiration requires effort and becomes prolonged.
• As exacerbation progresses, central cyanosis secondary to severe hypoxia may occur.
• Additional symptoms, such as diaphoresis, tachycardia, and a widened pulse pressure, may occur.
• Exercise-induced asthma: maximal symptoms during exercise, absence of nocturnal symptoms, and sometimes only a description of a “choking” sensation during exercise.
• A severe, continuous reaction, status asthmaticus, may occur. It is life-threatening.
• Eczema, rashes, and temporary edema are allergic reactions that may be noted with asthma.

Patients with recurrent asthma should undergo tests to identify the substances that precipitate the symptoms.

• Allergens . Allergens, either seasonal or perennial, can be prevented through avoiding contact with them whenever possible.
• Knowledge. Knowledge is the key to quality asthma care.
• Evaluation. Evaluation of impairment and risk are key in the control.

Complications for asthma include the following:

• Status asthmaticus . Airway obstruction in status asthmaticus often results in hypoxemia .
• Respiratory failure . Asthma, if left untreated, progresses to respiratory failure.
• Pneumonia . Mucus that pools in the lungs and becomes infected can lead to the development of pneumonia .

To determine the diagnosis of asthma, the clinician must determine that episodic symptoms of airway obstruction are present.

• Positive family history . Asthma is a hereditary disease, and can be possibly acquired by any member of the family who has asthma within their clan.
• Environmental factors . Seasonal changes, high pollen counts, mold, pet dander, climate changes, and air pollution are primarily associated with asthma.
• Comorbid conditions . Comorbid conditions that may accompany asthma may include gastroeasophageal reflux, drug-induced asthma, and allergic broncopulmonary aspergillosis.

Medical Management

Immediate intervention may be necessary, because continuing and progressive dyspnea leads to increased anxiety , aggravating the situation.

• Short-acting beta 2 – adrenergic agonists . These are the medications of choice for relief of acute symptoms and prevention of exercise-induced asthma.
• Anticholinergics . Anticholinergics inhibit muscarinic cholinergic receptors and reduce intrinsic vagal tone of the airway.
• Corticosteroids. Corticosteroids are most effective in alleviating symptoms, improving airway function, and decreasing peak flow variability.
• Leukotriene modifiers. Anti Leukotrienes are potent bronchoconstrictors that also dilate blood vessels and alter permeability.
• Immunomodulators . Prevent binding of IgE to the high affinity receptors of basophils and mast cells.

• Peak flow meters. Peak flow meters measure the highest airflow during a forced expiration.
• Daily peak flow monitoring. This is recommended for patients who meet one or more of the following criteria: have moderate or severe persistent asthma, have poor perception of changes in airflow or worsening symptoms, have unexplained response to environmental or occupational exposures, or at the discretion of the clinician or patient.
• Function. If peak flow monitoring is used, it helps measure asthma severity and, when added to symptom monitoring, indicates the current degree of asthma control.

Nursing Management

The immediate care of patients with asthma depends on the severity of the symptoms.

Assessment of a patient with asthma includes the following:

• Assess the patient’s respiratory status by monitoring the severity of the symptoms.
• Assess for breath sounds.
• Assess the patient’s peak flow.
• Assess the level of oxygen saturation through the pulse oximeter.
• Monitor the patient’s vital signs.

Based on the data gathered, the nursing diagnoses appropriate for the patient with asthma include:

• Ineffective airway clearance related to increased production of mucus and bronchospasm.
• Impaired gas exchange related to altered delivery of inspired O2.
• Anxiety related to perceived threat of death.

Main Article:  5 Bronchial Asthma Nursing Care Plans

To achieve success in the treatment of a patient with asthma, the following goals should be applied:

• Maintenance of airway patency .
• Expectoration of secretions .
• Demonstration of absence/reduction of congestion with breath sounds clear, respirations noiseless, improved oxygen exchange.
• Verbalization of understanding of causes and therapeutic management regimen.
• Demonstration of behaviors to improve or maintain clear airway.
• Identification of potential complications and how to initiate appropriate preventive or corrective actions.

The nurse generally performs the following interventions:

• Assess history. Obtain a history of allergic reactions to medications before administering medications.
• Assess respiratory status . Assess the patient’s respiratory status by monitoring the severity of symptoms, breath sounds, peak flow, pulse oximetry, and vital signs.
• Assess medications. Identify medications that the patient is currently taking. Administer medications as prescribed and monitor the patient’s responses to those medications; medications may include an antibiotic if the patient has an underlying respiratory infection .
• Pharmacologic therapy. Administer medications as prescribed and monitor patient’s responses to medications.
• Fluid therapy . Administer fluids if the patient is dehydrated.

To determine the effectiveness of the plan of care, evaluation must be performed. The following must be evaluated:

• Maintenance of airway patency.
• Expectoration or clearance of secretions .
• Absence /reduction of congestion with breath sound clear, noiseless respirations, and improved oxygen exchange.
• Verbalized understanding of causes and therapeutic management regimen.
• Demonstrated behaviors to improve or maintain clear airway.
• Identified potential complications and how to initiate appropriate preventive or corrective actions.

A major challenge is to implement basic asthma management principles at the home and community level.

• Collaboration. The complex therapy of treating asthma at home needs collaboration between the patient and the health care provider to determine the desired outcomes and to formulate a plan to achieve those outcomes.
• Health education. Patient teaching is a critical component of care for patients with asthma. Teach patient and family about asthma (chronic inflammatory), purpose and action of medications, triggers to avoid and how to do so, and proper inhalation technique. Instruct patient and family about peak-flow monitoring. Obtain current educational materials for the patient based on the patient’s diagnosis, causative factors, educational level, and cultural background.
• Compliance to therapy. Nurses should emphasize adherence to the prescribed therapy, preventive measures, and the need to keep follow-up appointments with health care providers. Teach patient how to implement an action plan and how and when to seek assistance.
• Home visits. Home visits by the nurse to assess the home environment for allergens may be indicated for patients with recurrent exacerbations.

Documentation is a necessary part of the nursing care provided, and the following data must be documented:

• Related factors for individual client.
• Breath sounds, presence and character of secretions , and use of accessory muscles for breathing.
• Character of cough and sputum.
• Respiratory rate, pulse oximetry/o2 saturation, and vital signs.
• Plan of care and who is involved in planning .
• Teaching plan.
• Client’s response to interventions, teaching, and actions performed.
• Use of respiratory devices/airway adjuncts.
• Response to medications administered.
• Attainment or progress towards desired outcomes.
• Modifications to the plan of care.

Posts related to Asthma:

• Asthma and COPD NCLEX Practice Quiz 1 (50 Items)
• Asthma and COPD NCLEX Practice Quiz 2 (50 Items)
• 5 Bronchial Asthma Nursing Care Plans

6 thoughts on “Asthma”

Perfect for students

I would like to use some of this key information in a student case study that I’m writing but am hesitant to do so because I don’t see enough information here about how to cite the reference. I suggest you add a widget/button that provides an APA style reference citation. It would also bring alot of free advertisement. : )

Thanks I really got what I wanted

You are really great, will like to meet you one day in America

Great lecture

Asthma can be treated but not cured for any means,all necessary step is to treat inorder to control asthmatic case according the issues cause asthma.

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Asthma Nursing Diagnosis: Identifying and Treating Asthma in Nursing

#i',$content, -1); --> table of contents asthma nursing diagnosis: what a nurse optioned to do importance of the nursing diagnosis for asthma identifying symptoms for the nursing diagnosis for asthma nursing assessment for asthma: before interventions main components of the asthma nursing care plan asthma nursing interventions and further patients’ support asthma is quite common among the many diseases that exist and are identified today. it’s a chronic disease affecting adults and children. yet, this is the most common among young patients. this diagnosis can be life-threatening sometimes, but it’s easy to control. with timely medical intervention and keeping under control, people with this health condition can live healthy, whole lives. according to the gbd (global burden of disease) study, 4.5% of the world’s population has asthma. the rates, though, vary widely by region as it’s all about diagnosis, treatment, and the combination of triggers. access to early diagnosis, effective asthma nursing care plan, and illness management play a decisive role in the statistics. while it’s difficult to influence triggers like the environment and ecology, disease definition and treatment are what the health system can manage. asthma nursing diagnosis: what a nurse optioned to do.

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Nurses play one of the leading roles in dealing with asthma and its diagnosis. A person comes to the hospital with respiratory problems, and the nurse is who gathers primary physical data and identifies symptoms in the aursing diagnosis for asthma. Although the doctor confirms the condition and prescribes medications, the initial nursing examination and individual interview are the foundation of further care.

The sick person’s further path lies through tests and analysis before making a nursing diagnosis . Then, the doctor conclude on it and the nursing care plan for asthma comes into play. This is an important document where the specialists must consider a number of factors: the patient’s condition, treatment goals, medication management, prevention of attacks, and lifestyle changes.

Importance of the Nursing Diagnosis for Asthma

Since asthma is a long-term, chronic condition with numerous health implications, receiving a timely nursing diagnosis for asthma is vital for the patient’s safety. By means of educating a patient on their condition and teaching them to recognize the symptoms of asthma attacks and exacerbations, nurses can contribute to the quality of life of this patient population. Besides, nurses may monitor the patient’s condition on a regular basis to adjust pharmacological and non-pharmacological interventions for optimal health outcomes.

Identifying Symptoms for the Nursing Diagnosis for Asthma

Asthma nursing diagnosis is the first stage of the nurses’ part. The nursing diagnosis for asthma patient plays a significant role in defining asthma but is only the first in the sequence of assessment, care, and intervention parts. The first thing that healthcare specialists determine is the individual’s complaints. They consider symptoms of an asthma respiratory disease the person came in with.

It is worth mentioning that people are least likely to visit a hospital with early symptoms since they can take them as other diseases. The sadness here is that most often, individuals come to a hospital after the fact of an attack, having late signs. They and advanced conditions are more challenging to manage but easier to determine in the nursing diagnosis asthma.

Early symptoms:

• Chest tightness
• Shortness of breath
• Racing heart

Asthma attack symptoms:

• Severe cough
• Feeling of air hunger
• Restlessness

Severe symptoms:

• Night cough
• Morning cough
• Dyspnea on exertion
• Dyspnea on talking
• Dyspnea at rest

There are a variety of guidelines on the severity to define in the nursing diagnosis on asthma. The most common NAEPP classification includes four levels: intermittent asthma, mild persistent, moderate persistent, and severe persistent. This classification will serve as the future diagnosis and medication support foundation.

After identifying symptoms and further examination, it is time to start thinking about how to write a nursing care plan that will align with the sick individual’s needs.

Nursing Assessment for Asthma: Before Interventions

Before planning nursing interventions for asthma, the nurse has a more global task at hand. It is not just about stating facts but also about determining a course of action. Patients with these diagnosed asthma need more than just a medication plan based on signs. They need to know how to live in the new conditions and adapt to their new reality.

First and foremost, the specialists must define the severity of a person’s condition and identify the disease’s exacerbation risk factors. Nursing assessment for asthma creates the foundation for further support. So, it is crucial to collect information thoroughly. The patient’s functional abilities, knowledge of the disease, resources, and level of support from family and friends will most shape and personalize the care plan.

Main Components of the Asthma Nursing Care Plan

The nursing care for asthma plan is a document summarizing the patient’s current condition, medication intervention, and a list and order of steps to help the ailing adapt to the disease. It is a kind of asthma manual that outlines a step-by-step guide to getting out of severe attack symptoms and preventing them in the future.

The care plan has main priorities that determine the direction of the nursing management of asthma:

• Control and care. Since asthma is a chronic disease, the first step is to control it. The next moves will include minimizing symptoms, improving quality of life, and preventing exacerbations.
• Awareness and management. People should know about their health condition, its triggers, ways to prevent attacks, and the importance of following the medication regimen.
• Schedule. The patient must take his medications correctly and regularly to control his illness.

These three priorities should come first regardless of your task – making a plan or writing an essay about asthma . Within academic studies, you also may be assigned to look at each priority separately, digging deeper into each one.

Asthma Nursing Interventions and Further Patients’ Support

Improvement in the patient’s condition and their adaptation is largely due to the nursing staff. This is a huge theoretical and practical part related to nursing interventions for asthma. A nursing intervention for asthma is a complex of measures including medical care, psychological support, and education about the individual’s health and related concerns.

In more detail, asthma nursing interventions are practical help to patients in their struggle for a normal life. Interventions may include:

• Explaining the diagnosis and teaching how to manage it.
• Guiding on the use of inhalers and prescribed drugs.
• Recognizing the early symptoms of the attack.
• Developing an action plan in case of an attack, which covers a nursing diagnosis for asthma exacerbation.
• Supporting the patient in following their treatment plan.
• Helping with lifestyle changes.

Every person is an individual. Each patient has their own genetic history, triggers, and symptom patterns. It is important to remember that the exact nursing diagnosis, any care plan, or any medication prescription is only within the competence of doctors and nurses.