About
Airway obstruction caused by either constriction, bronchospasm, or inflammation.
Assess
Monitor airway, auscultate lung sounds, stridor ( indicates a respiratory airway emergency), inspiratory wheezes, expiratory wheezes, cyanosis, pulse oximetry, history of allergies, exposure to toxins or allergens, assess respirations, use of accessory muscles ( intercostals, diaphragm, etc), ease of breathing, triggers to asthmatic episodes. Medication history.
Complications
Status asthmaticus- administer medications prescribed by doctor to reverse airway obstruction, including antiinflammatories, bronchodilators, epinephrine, and O2.
Emergency intubation- if obstruction does not respond or client goes into cardiac or respiratory arrest, emergent endotracheal intubation may be necessitated.
Diagnosis
Airway obstruction caused by either constriction, bronchospasm, or inflammation.
Assess
Monitor airway, auscultate lung sounds, stridor ( indicates a respiratory airway emergency), inspiratory wheezes, expiratory wheezes, cyanosis, pulse oximetry, history of allergies, exposure to toxins or allergens, assess respirations, use of accessory muscles ( intercostals, diaphragm, etc), ease of breathing, triggers to asthmatic episodes. Medication history.
Complications
Status asthmaticus- administer medications prescribed by doctor to reverse airway obstruction, including antiinflammatories, bronchodilators, epinephrine, and O2.
Emergency intubation- if obstruction does not respond or client goes into cardiac or respiratory arrest, emergent endotracheal intubation may be necessitated.
Diagnosis
- Ineffective breathing pattern related to anxiety
- Anxiety related to inability to breathe effectively
- Ineffective airway clearance related to narrowed airway and excessive mucous production
- Activity intolerance related to inability to breathe effectively
Goals
- The client will have a decrease in the amount of asthma attacks.
- The client will be able to correctly administer prescribed inhalers.
- The client will be able to state three interventions necessary during an acute asthma attack.
Interventions
- Monitor clients lung sounds frequently for acute changes; if stridor ( harsh wheezing upon inspiration and expiration) is present, seek additional emergent treatment.
- Monitor VS every shift, including pulse oximetry.
- Administer IV steroids, as prescribed, making sure the client understands the need to taper the dose when discontinuing.
- Administer inhalers, making sure to wait five minutes in between each inhaler. Bronchodilators should be first before antiinflammatories.
- Teach client to deliver own inhaler. Assess need for a spacer or additional teaching needs.
- Teach client trigger management for asthma, including pre-treatment prior to exercise and avoiding allergens and other triggers.
- Encourage the use of a peak flow meter to monitor for changes and need for alterations in treatment.
- Monitor for signs/ symptoms of complications.
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