The immediate nursing care of patients with asthma depends on the clinical manifestations, severity of symptoms and response to treatment.
In addition from the administering supplemental oxygen or administration of bronchodilators medication the two high priority nursing strategies that can be used to manage a child with a severe acute exacerbation of asthma is to calm the child and maintain the child’s airway.
A child having asthma attacks is usually panicking due difficulty of breathing, which includes shortness of breath and use of accessory muscles. The child is grasping for air due to narrowing of the airway and inflammation of the respiratory tract. Teaching the child to relax and instruct the child to control his breathing by doing deep breathing exercise would help him to control his breathing and reducing hyperinflation.
Maintaining the patency of the airway is the also
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It blocks the effect of acetylcholine on airways such as bronchi and nasal passages. Acetylcholine is a chemical that nerves use to communicate with muscle cells. Cholinergic nerves going to the lungs cause narrowing of the airways by stimulating muscles surrounding the airways to contract. The "anti-cholinergic" effect of ipratropium blocks the effect of cholinergic nerves, causing the muscles to relax and airways to dilate. By blocking acetylcholine, ipratropium helps relieve symptoms caused by allergens or irritants and preventing secretion of mucus by mucus glands in the nose. When inhaled, ipratropium travels directly to airways, and very little is absorbed into the body.
These drugs help to increase the patency of the airway and reducing the amount of mucus will result increase airflow balancing the breathing, V/Q ventilation and perfusion will start to normalize and later on will help the child to breath more easily and gradually reduce the sign and symptoms of dyspnoea such wheezes, hyperinflation and respiratory muscle
Asthma is a serious problem nationwide. It is also a significant problem in the state of Massachusetts, especially in communities in Boston. However, according to Harvard School of Public Health and NIEHS Center for Environmental Health, Roxbury and North Dorchester are highly noticeable hotspots (Backus, Terrell, Wool, & Straubel, 2012, p. 23). For the purpose of this paper, the main focus will be on asthma cases in
History of Present Illness: Ms. Dahlberg is a very pleasant 69-year-old woman who suffers from poorly controlled asthma. She has a recent exacerbation requiring hospitalization at Anna Jaques Hospital in June. Since discharge, she states that she has done well. She has stable dyspnea on exertion. She does feel that perhaps it might be slightly worse given the heat and humidity. She is not complaining of any cough. She is compliant with her bronchodilator regimen.
While unfortunately asthma is not a curable disease, for most asthmatics its can be well controlled meaning there will less symptoms or flare-ups and limits to your life. With correct medication, knowledge about the disease and skills, asthma shouldn’t stop you. There are many treatment options available when it comes to asthma. Asthma treatments vary from your basic asthma inhalers to steroids and other anti-inflammatory medicines and asthma nebulizer (Breathing Machine). (Anon., n.d.) The role that medical practitioners play with asthma is a very precise job. This role includes assessment, diagnosis, prescription of regular medications, provision of written action plans, and regular review as well as managing asthma flare-ups. Asthma-related visits to a general practitioner may occur for a variety of reasons, including: the acute or reactive management of asthma symptoms, a visit for maintenance activities, such as monitoring and prescription of regular medications and referral to other health professionals. (Anon.,
• Decreased SOB, decreased crackles in the bases of the lungs, and possibly decreased O2
This assignment will discuss the nurse's role in devising of a care plan for a patient, including the rationale upon which this care plan has been based, evaluating that the goals intended are met or amended. The patient's identity will be protected using a pseudonym of Kora in keeping with the standards of maintaining confidentiality set by Nursing and Midwifery (NMC, 2015). The patient has Chronic Obstructive Pulmonary Disease (COPD) which is a long-term health condition which is slowly progressive, cause’s obstruction to airway that cannot be reversed, alterations in breathing with exacerbation often suggesting worsening of the disease (Currie, 2007). Kora is 63 years has three young grandchildren permanently in her care, Kora being in
When an asthmatic takes an inhaler “Albuterol sulfate”, the medication works by reducing the inflammation in the airway paths “bronchi and bronchioles” of the lungs, allowing the patient to breath without constriction or symptoms of asthma.
This assignment is a case study of a patient who was admitted to a respiratory ward with acute exacerbation of asthma. This assignment will discuss nursing an adult patient with asthma, also it will aim to critically assess, plan, implement and evaluate the patients nursing needs using the Roper, Logan and Tierney nursing model (1980). This case study will focus on the maintaining a safe environment. It is worth noting that the activities of daily living are interlinked e.g. according to Roper et al (1980) breathing is an activity that is crucial for life therefore all other activities are dependent on us being able to breathe. The nursing management, pharmacological agents and the tools used will be critically
Theophylline is one example of xanthine that is usually used to treat bronchial asthma through relaxing the airways. However, this drug may cause severe adverse effects because of its level in the blood. Thus, it is important to teach patient about the use of theophylline. Teach a patient that theophylline can help him to breath easier, decrease wheeze and short of breath if taken exactly as prescribed. The nurse should also tell the patient take the drug of an empty stomach with a full 8-ounc glass of water. If patient has a severe GI problem such as GI upset, nausea, vomiting, heartburn when taking the drug on an empty stomach, the patient may take the drug with food. The patient should swallow all the enteric-coated or time-release capsules. Educating the patient about other common effect of the drug includes restlessness, nervousness, and difficulty in sleeping because of the need of the body to adjust to the usage of this drug. The patient should not take any other stimulant in order to reduce the effect of theophylline on CNS. The nurse should tell the patient that a headache will go away as the patient get used to the drug. However, the patient should notify his physician if the headache is getting worse. The patient should also report any vomiting, severe abdominal pain, tachycardia, confusion, unusual tiredness, muscle twitching, rash, or hives to the physician. There are many drug and food interaction, thus the patient should consult with the doctor about his diet while using theophylline. Additionally, the patient should consult his smoking habit and the use of any over-the-counter medication with the physician. Lastly, the patient should always tell any health care provider in his care about the use of theophylline and to keep the medication in a safe place (Karch, 2013, p.
The team will navigate patients through the program, resources and pulmonary rehabilitation. The registered nurse will meet with the patient prior to discharge to evaluate and refer them to the appropriate services along with the social worker, which may find alternative way to pay for patients medication and other support services that may be offered. The nurse practitioner and the respiratory therapist will see the patient within 48 of hours upon admission into program. The nurse practitioner and respiratory therapist will evaluate the needs at home and enroll the patient in pulmonary rehabilitation, which will be part of the care offered to all patients. Resources for the patient will consist of a 24-hour hotline for patients who may need to seek medical advice prior to going to the emergency room. Patient will be supplied with emergency medications for home use if symptoms begin to appear. A nurse practitioner will be available to advice the patient in intervention with the emergency medications is indicated and advice if treatment may need to be continued in the emergency room. With the protocols in place for medications, the patient will be seen within 12 hours if use of the emergency medications were taken in the home. The nurse practitioner will update the electronic medical chart of the patient to document
The main priority for all the pediatric patient was to make sure they are getting enough air. They needed an open airway. Without an open airway nothing else matters. To help with the patients airways we monitored their O2 sats and if they were low we made sure to apply oxygen, and continue to monitor their sats. Once oxygen was applied we worked on
Asthma triggers and response to medications does not affect individuals in the same ways. Moreover it is not always simple to manage due to its affectability on people on age, sex and ethnic background (Cockett,2003). However, specialist nurse can achieve a successful outcome by ensuring that management plans are tailored to suit each patients/clients needs.
A screening template can be developed that can assist the nurse in performing a thorough assessment of an asthmatic patient. This questionnaire should be at an appropriate education level and question should be simple and direct. The questions should focus on the presence or absence of symptoms, activity limitations, exacerbations, missed workdays, and frequency of use of prescribed medications.
A physiological process of asthma is hyperventilation. In the case of Joseph, his conditions appear to be triggered by vigorous exercise and worsened upon exposure to cold, dry air. Thus during or following physical activity, Joseph may experience an asthma attack. During this process, the individual’s heart rate will increase because their breathing is so rapid. As a result, too much carbon dioxide is exhaled from the body and blood vessels constrict, providing an insufficient supply of blood throughout the body. Joseph may then experience dizziness, tingling of the hands, lips or feet and an overall decrease in strength. Moreover, air will remain trapped within the alveoli and significantly limit airflow. The patient must work harder to breathe
Nurses are a vital component in patient care. The importance of conducting efficient nursing assessments is critical in order to provide both patient-centered care and safe, effective patient healing. Nurses are often responsible for taking care of patients with very complex disease processes. They frequently provide care to patients with illnesses such as Chronic Obstructive Pulmonary Disease (COPD). According to the Centers for Disease Control and Prevention, in 2014, approximately 6.8 million adults were diagnosed with COPD within the Unites States. The completion of proper assessments and initiation of interventions for these patients are crucial in order to prevent further complications of the illness.