Asthma

Subject: Nursing Process and Critical Thinking

Teacher: Laisa Camille D.LubidPresented by Group: 4

Asthma

What is asthma?Asthma is a long term lung disease, that inflames and narrows the airways. Asthma causes chest tightness, shortness of breath, coughing, and wheezing.

How do you get asthma?

What Happens When the Lungs Don't Work Right?

As your asthma worsens, three primary asthma pathophysiology changes take place in your lungs:• Increased Mucus• Inflammation and Swelling• Muscle Tightening

Signs and Symptoms • Sudden dyspnea• Wheezing• Tightness in the chest• Diminished breath sounds• Coughing• Thick, clear, or yellow sputum• Rapid pulse• Tachypnea• Use of accessory muscles for breathing

How do you lose asthma?

Asthma is incurable but there is medications that can slow it down. Inhalers having air inside them

that give you air when you’re having an attack.

Case studyMs. Jane, a 37 years old female with a history of

asthma, presents to the ER with tachypnea, and acute shortness of breath with audible wheezing. She complained that “I cannot breath’’. Ms. Jane has taken her prescribed medications of Cromolyn Sodium and Ventolin at home with no relief of symptoms prior to coming to the ER. A physical exam revealed the following: HR= 110 bpm, RR= 40 bpm with signs of accessory muscle use and the patient state is restlessness and cyanosis. Auscultation revealed decreased breath sounds with inspiratory and expiratory wheezing and she was coughing up small amounts of white sputum. SaO2 was 85% on room air. An arterial blood gas (ABG) was ordered with the following results: pH= 7.5, PaCO2= 27mmHg, PaO2= 75mmHg.

Nursing Diagnoses:1. Ineffective breathing pattern r/t presence of

secretions AEB productive cough and dyspnea.2. Impaired gas exchange r/t ventilation perfusion

imbalance AEB dyspnea, RR= 40 bpm, and HR= 110 bpm.

3. Ineffective airway clearance r/t increased mucus production AEB wheezing, dyspnea, cough, and sputum

4. Fatigue r/t physical exertion to maintain adequate ventilation AEB use of accessory muscles to breath.

5. Risk for activity intolerance r/t decreased oxygenation.

Two Priorities of Nursing Diagnoses 1. Ineffective breathing pattern r/t presence

of secretions AEB productive cough and dyspnea.

2. Impaired gas exchange r/t ventilation perfusion imbalance AEB dyspnea, RR= 40 bpm, and HR= 110 bpm.

Nursing Care PlanProblem: Ineffective Breathing Pattern r/t Presence of Secretions Assessment

Nursing Diagnosis

Planning Interventions

Rationale Evaluation

Subjective data: “I cannot breath.” as verbalized by the patient.

Objective data:>wheezing upon inspiration and expiration>Acute shortness of breath>dyspnea

Ineffective breathing pattern r/t presence of secretions.

Patient will manifest signs of decreased respiratory effort AEB:>Absence of dyspnea, cough, and sputum.

Pattern of breathing effective be mark on normal breath sound and O2 saturation normal AEB:

1. V/S monitor and record

2. Auscultate breath sounds and assess airway pattern

3. Place the patient in semi-fowler position or three-point position.

1. To follow up the important changes

2. to check for the abnormal breath sounds

3. To minimize difficulty in breathing

Problem: Ineffective Breathing Pattern r/t Presence of Secretions. (cont.)

Assessment

Nursing Diagnosis

Planning Interventions

Rationale Evaluation

>coughing, sputum is white >cyanosis>SaO2= 85%>V/SRR: 40 bpmHR: 110 bpmBP: 130/90 mmHgTo: 36.8oc

>Breathing remained within normal limits>Breathing, not difficult>Does not use aids breathing muscle.

Patient will verbalize understanding of causative factors and demonstrate behaviors that would improve breathing pattern

4. Demonstrate diaphragmatic, pursed-lip breathing, and coughing exercises.

5. Encourage opportunities for rest and limit physical activities.

4. To maximize effort for expectoration.

5. To prevent situations that will aggravate the condition

Problem: Ineffective Breathing Pattern r/t Presence of Secretions. (cont.)

Assessment

Nursing Diagnosis

Planning Interventions Rationale Evaluation

6. Keep environmental pollution to a minimum according to individual situation.

7. Increase fluid intake to 3000ml/ day.

6. Precipitators of allergic type of respiratory reactions that can trigger or exacerbate onset of acute episode.

7. Hydration helps thin secretions, facilitating expectoration and using warm liquids may decrease bronchospasm.

Problem: Ineffective Breathing Pattern r/t Presence of Secretions. (cont.)

Assessment

Nursing Diagnosis

Planning Interventions Rationale Evaluation

8. Provide O2 as ordered.

8. To maintain normal O2 in the body.

Nursing Care PlanProblem: Impaired Gas Exchange r/t Ventilation Perfusion Imbalance Assessment Nursing

Diagnosis

Planning

Interventions

Rationale Evaluation

Subjective data:“I cannot breath”said the patient

Objective data:>dyspnea>restlessness>cyanosis>SaO2= 85%>ABGs resultPH= 7.5PaCO2=27mmHgPaO2=75mmHg>V/S:RR: 40 bpmHR: 110 bpmBP: 130/90 mmHgTo: 36.8 oc

Impaired gas exchange r/t ventilation perfusion imbalance.

Patient will improve gas exchange AEB :>Absence of cyanosis>V/S is in normal limit

Patient will demonstrate improved ventilation and adequate oxygenation of tissues AEB:

1. V/S monitor and record

2. Auscultate breath sounds and assess airway pattern

1. Changes in the vital sign will show the disease’s progress or client’s progress

2. to check for the presence of adventitious breath sounds

Problem: Impaired Gas Exchange r/t Ventilation Perfusion Imbalance. (cont.)

Assessment

Nursing Diagnosis

Planning Interventions Rationale Evaluation

>ABG’s within client’s normal limits

Maintain client comfort AEB:>Assessing ease of breathing every 4 hours.

3. Elevate head of the bed and change position of the pt. every 2 hours.

4. Encourage deep breathing and coughing exercises.

5. Encourage opportunities for rest and limit physical activities.

6. Provide O2 ventilation

3. To minimize difficulty in breathing.

4. To maximize effort for expectoration.

5. To prevent situations that will aggravate the condition

6. To increase O2 perfusion in the body.

Thanks You!