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Asthma
From the slides
24
Nursing
Undergraduate 1
02/22/2012

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Cards

Term
What is the primary pathological complication with asthma?
Definition
Inflammation (then bronchospasms)
Term
Asthma exacerbations are ______ and classified in what three categories?
Definition
Episodic, mild, moderate and severe where mild asthma can have severe exacerbation.
Term
Airway inflammation is ____ whether or not sx are present.
Definition
Chronic
Term
____ is crucial to preventing problems w/ asthma
Definition
EDUCTION.
Term
What are objective data collected during asthma assessment?
Definition
Peak flow meters (Airflow obstruction), spirometry and exhaled nitric oxide, allergy testing
Term
What are the rescue meds?
Definition
Short acting Beta 2's [relx smooth muscles in broncho airways], anticholinergics [PSNS induce bronchodilation], oral steroids [30'-1hr]
Term
what are the asthma controller meds?
Definition
inhaled corticosteroids, anti leukotrienes, long acting beta 2's, MDI, Dry powder inhalers
Term
What is the first sx of an asthma attack?
Definition
Cough
Term
What does Spirometry do?
Definition
Helps with diagnosis and ongoing treatment; Measures OBSTRUCTION to airflow in airways for children
Term
how often do kids with mild asthma need to be seen? Mod-severe?
Definition
Annually, quarterly
Term
What is eNO measurement?
Definition
Objective, a measure of eosinophillic inflammation, serial measurement reflects AIRWAY INFLAMMATION, 5-15ppb normal value
Term
What are some triggers that are also allergens?
Definition
Cold air, strong emotions, exercise, odors, SMOKE, windy/dusty days, foods
Term
Acute asthma exacerbations occur in what two phases?
Definition
Early phase (minutes of exposure)--bronchospasm and inflammation [b2a-->immedeate bronchodilator]; Late Phase 6-9 hrs later, leads to broncial hyperresponsiveness [mast cell degranulation sx get worse over time] that can become chronic and requires anti-inflammator meds AND bronchodilators.
Term
What is the biggest trigger of all?
Definition
the COLD VIRUS
Term
Early symptoms include:
Definition
COLD SYMPTOMS (cough, chest tight, SOB, throat clearing, less active)--Low PCO2 and Tachypnea (trying to blow off CO2), EXPIRATORY wheeze
Term
Late Symptoms include:
Definition
Coughing/Vomiting, Inspiratory WHEEZING (a late sign of inflammation), Stop to breath when talking OMINOUS, trouble walking normal distances, anxiety, accessory muscles, insp&expir wheezing, head bobbing
Term
What are the goals of the asthma guidelines?
Definition
How severe is their disease and how well controlled it is before determining treatment.
Term
How is severity assessed?
Definition
Before tx or if already diagnosed it is inferred by what meds are needed to achieve control
Term
How is control assessed?
Definition
By how symptomatic the child is ON THEIR MEDS and how at risk they are for exacerbation
Term
What are the four Rules of Two? IF YOU ANSWER YES TO ANY OF THE RULES OF 2, what does that mean?
Definition
Does your child: need albuterol more than 2xweek, asthma sx at night more than 2xmonth (KEY!!), Refill rescue meds more than 2xyr, Measure a peak flow at less than 2x10 or 20% from personal best blow?--Asthma is NOT under control, requires a controller med, child has reached PERSISTANT asthma level
Term
Asthma is a ____ inflammatory disease but we notice ____ sx.
Definition
CHRONIC, episodic
Term
What is the progression of asthma over time?
Definition
Inflammatory cells present in airways-->Results in HYPERREACTIVE/HYPERsensitized airways which when triggered become further inflammed-->inflammation leads to congestion and bronchiol constriction
Term
After an acute asthma attack, which airways take months to normalize?
Definition
the small airways (MMEFR)--max mid expiratory flow rate
Term
What are the asthma mortality risk factors?
Definition
Past Hx of sudden attacks, prior intubation/ICU admission, >= 2 hospitalizations in last 12 mos or 3 ER visits in last 12 mos, >= 2 cannisters SABA/mo [also oral steroid use, poor preciever sx, outdoor MOLD ALLERGY, mental health, drugs, poor/urban]
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