PAPER OF ASTHMA CASE STUDY Compiled to Fulfill Adult Nursing Task Oxigenation Module Created by : Sitha R. Amanatunnisa G2B 009 031 Destya D. Pangestika G2B 009 044 Mitsalina Maulida Hafidz G2B 009 050 Safina Aprillia G2B 009 059 Class A09 2 NURSING SCIENCE PROGRAM
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
PAPER OF ASTHMA CASE STUDY
Compiled to Fulfill Adult Nursing Task
Oxigenation Module
Created by :
Sitha R. Amanatunnisa G2B 009 031
Destya D. Pangestika G2B 009 044
Mitsalina Maulida Hafidz G2B 009 050
Safina Aprillia G2B 009 059
Class A092
NURSING SCIENCE PROGRAM
FACULTY OF MEDICINE
DIPONEGORO UNIVERSITY
OCTOBER, 2010
1st CHAPTER
PREFACE
A. Background
Asthma is a worldwide health problem, both in developed and in
developing countries. In addition, asthma is a disease known in the community.
This is different about a century ago, for asthma disease was first discovered
and is still relatively rare. In the 1970s, more and more asthma sufferers are
found, this disease can be deadly even for reasons that are unclear. In the
United States for example, if heart disease and cancer are still occupying the
top position in the list of diseases spreading death, the lung disease is now
ranked third. And among the categories of lung diseases are fatal, chronic
asthma, including one of them.
WHO’s data (World Health Organization) indicates the number of asthma
sufferers in Indonesia ranges from 3-8 percent, or 6-16 million of the 200
million population. Another survey from various hospitals showed the number
of asthma sufferers in some provinces, namely Bali (2.4 percent), East Java (7
percent), Jakarta for the children (16.5 percent), Malang for children (22
percent) , East Jakarta for adults (18.3 percent), and Central Jakarta (7 percent).
Asthma is a chronic airway inflammatory disease involving various
immune cells, especially mast cells, epithelial cells, and the increased response
of the airways (bronchial hipereaktivitas) to various stimulants. Asthma can be
mild and do not interfere with the activity, but can be settled and not disturbs
daily activities and even activities reduce the quality of life.
But unfortunately, not all aspects of the pathophysiology of asthma as a
whole is understood to arise from the opinions of some doctors and the public
that asthma is a disease that is simple and easily treated, assuming that
management is the main thing is particularly bronchodilator drugs. Then show
habits of physicians and patients to overcome the symptoms of asthma are
particularly against the symptoms of shortness of breath and wheezing with
drug use and instead of managing asthma in full.
B. The Goals
This paper has eleven points to pass the goal of learning objective,
namely:
1. Students can find out the definition of asthma.
2. Students can find a variety of causes of asthma.
3. Students can find out all kinds of asthma.
4. Students can find out stages of asthma.
5. Students can find out three reactions in the pathology of asthma.
6. Students can learn how to forced expiratory.
7. Students can find pictures of X-Ray lungs
8. Students can learn the tools used in the investigation of asthma.
9. Students can learn the process of bronchial provocation test.
10. Students can find a variety of asthma medications.
11. Students can learn how to diagnose asthma and nursing interventions.
2 nd CHAPTER
LITERATURE REVIEW
A. Definition and types of Asthma
Asthma is a chronic disease characterized by recurrent attacks of
breathlessness and wheezing, which vary in severity and frequency from
person to person. Asthma is divided into two categories, namely :
1. Extrinsic or allergies
Marked by allergic reactions caused by factors specific trigger, such as dust,
animals, influenza virus, pneumonia,Mycoplasma, food, cigarettes and
drugs.
2. Non allergic
Characterized by non-allergic reaction which reacts to triggers that are not
specific or unknown, such as cold air or can also be caused by respiratory
infections , emotion, exercise, and environmental pollution. Asthma attacks
became more severe and often in line with the passage of time and can
develop into chronic bronchitis and emphysema. Some patients will
experience asthma combined.
B. How a proper forced expiratory test is to be performed.
The function of proper force expiratory test is to know how the condition
of respiratory system then it identified how long someone can not breath and
how much the carbon dioxide volume of force respiration process. This way is
suitable for identifying asthma patient and reducing the symptom of asthma. A
kind of proper forced expiratory test is the buteyko method. The Buteyko
method has five steps, they are :
a. Sit, relax, breathing regularly during 30 second
b. Inpiration and expiration as usuall
c. Close your nostril and start a stopwatch
d. Don’t breath until you feel oxigenation needs then breath maximally
e. See the stopwatch. How long you didn’t breath. It is you control pause time.
After we have done the buteyko method, we analysize how long we can not
breath. These are the result of proper forced expiratory test :
Control pause time The meaning of forced expiratory time
Less than 10 second Someone has respitory system disorder
10 – 25 second He/she should be more attention to check up
30 – 40 second Good respiratory system
More than 60 second It is en excellent respiratory system and its so
healthy
From that test, we can know the difference between forced expiratory
volume and vital capacity. Forced expiratory volume in one second (FEV 1.0)
is the volume of air that can expiratoried during the first second expiratory vital
capacity in the determination. Then, Peak flow is the patient's maximum speed
of expiration, or also called peak expiratory flow rate (PEFR or PEF) and
normally value is 250/250. Whereas vital Capacity (VC) is maximum volume
of air that can be spent during a one-time breathing after maximum inspiration.
Vital capacity is usually about 80% of the total lung capacity (4800 ml). Vital
capacity (VC). This is the amount of air (in liters) moved out of the lung during
normal breathing. The patient is instructed to breathe in and out normally to
attain full expiration.
C. Pathophisiology of asthma
These are three primary pathologic reactions:
a. The bronchi muscles do vasoconstriction (stricture of bronchi muscle).
Because the duct of air is too narrow, so the airs have difficulty to out
from the body. It can make wheezing voice, because the duct and air have
friction.
b. In bronchi, there is some of mucosa. If the mucosa is too much, it can
make edema so the airway is disturbed. The air will get difficulty to out
from the body in bronchi area, because there is edema. So, the person who
has this condition will be feeling congested. In edema bronchi, there is
much substance like histamine, leukotrien, and serotonin.
c. The third is cough effect. In gland of bronchial, there are so much mucosa
fluids. Because the mucosa fluids is abnormal, it can make hyper secrets.
This condition make production of mucosa has abnormal, so the cilia
difficult to move. It can make cough as effect of body from the abnormal
mucosa production.
A person who has allergy have ability to make much antibody Ig E in big
volume. This antibody can make allergy reaction if the reaction with
specification of antigen. In asthma, this antibody patch in mast cell which the
location in lung interstitial that is have relation with bronchial and small
bronchi.
If the person inhale allergen so the antibody of Ig E will be increase,
allergen will reaction with antibody in mast cell. This condition can make mast
cell will be releasing many substance like histamine, anafilaksis (acute allergy
reaction) that is slow reaction (leukotrient), and bradikinin.
The merger effect from all of this factors will be releasing local edema in
small bronchia’s wall and mucus secretion in bronchial lumen and spasm of
bronchial artless muscle so it can make person will get difficulty in breath.
D. Recognize chest x-ray changes seen with asthma
the normal lungs the asthma lungs
In the picture above shows a picture torax in normal circumstances. In the
state of asthma torax look bigger and expanded. This is caused by
inflammation resulting in swelling. And the white shadows in the asthma lungs
are the mucus and the eudema. Beside that, the asthma patient has chest
deformity become a barrel chest. And it is the barrel chest picture :
E. Recognize the signs and symptoms of asthma
To evaluate signs :
a. Chest deformity
Functional residual capacity and residual lung volume to be greatly
increased during an asthma attack due to difficulties expiratory air
out of lungs. This can cause the barrel chest.
b. Cyanosis
Cyanosis effects is a blue color of the skin and nails may occur
from lack of oxygen.
c. Chest and stomach pain
Those happened because the abdomen and thorax’s muscle involve
during respiration process.
The chest is bigger because there are so many carbon dioxide.