About
Severe asthma attack that does not respond to baseline interventions. Life-threatening.
Assess
Labored breathing, use of accessory muscles, wheezing, stridor, decreased pulse oximetry.
Complications
Respiratory arrest, mechanical ventilation, death from asphyxiation.
Diagnosis
- Impaired gas exchange related to partial or complete airway obstruction
- Anxiety related to health status.
Goals
- The client will maintain a patent airway.
- The client will be able to demonstrate effective anxiety reducing strategies.
Interventions
- Assess airway and monitor vital signs closely and frequently.
- Monitor telemetry and blood pressure continuously.
- Have emergency intubation equipment at the bedside.
- Administer nebulizers including short acting beta2 agonists ( albuterol) followed by corticosteroids ( inhaled and IV).
- Administer oxygen via nonrebreather.
- Monitor for signs of fatigue, ineffective breathing patterns, respiratory acidosis which may require mechanical ventilation.
- Maintain IV therapy to prevent dehydration and promote loosening of thick secretions in the airway.
- Encourage rest and energy conservation during acute illness.
- Administer anxiolytics as prescribed by physician.
- Teach breathing techniques, guided imagery, and other methods to decrease anxiety.
- Teach client about irritants that can precipitate an acute asthma attack.
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