• Asthma
o Intermittent obstructive airways
o Reversible, not progressive
o Risk Factors:
▪ Tobacco use
▪ GERD
▪ Air Pollutants
• Smog
• Dust
• Pollen
▪ Smoking
▪ Allergies
▪ Genetics is the most common
• The more risk factors, the more likely they will develop asthma
o Signs and Symptoms:
▪ Wheezes
▪ Chest tightness
▪ Persistent cough
▪ Dyspnea
o Early Symptoms:
▪ Increase pH
• Respiratory alkalosis
▪ Restlessness
▪ Agitation
▪ Tachycardia
▪ Tachypnea
▪ Anxiety
o Late Symptoms:
▪ Bradycardia
▪ Cyanosis
▪ Stupor
▪ Body gets tired when body is undergoing respiratory alkalosis->
respiratory acidosis -> respiratory failure
o If pt has chest tightness and coughing, what are some nursing interventions?
▪ Give O2 in a hospital setting
▪ Use a rescue inhaler if not in a hospital
, o Patient
Teaching:
▪ Prevention
• Ways to prevent developing an asthma attack
• Avoid triggers
o ABG Interpretation/Analysis
▪ pH 7.35-7.45
• Below: Acidosis
• Above: Alkalosis
▪ HCO3 22-26
• Below: Acidosis
• Above: Alkalosis
▪ CO2 35-45
• Below: Alkalosis
• Above: Acidosis
▪ Uncompensated
• pH is out of range
▪ Compensated
• pH is normal
• CO2 and HCO3 out of range
▪ Partially Compensated
• Everything is out of range
o Best way to diagnose asthma
▪ Pulmonary function test
• Uses incentive spirometry ->take the levels of bronchodilators -
> retake incentive spirometry -> of the levels increased = pt has
asthma
▪ Patient Teaching:
• No bronchodilators and no smoking
o 6-12 hours before
o Medications for Asthma
▪ Beta 2 adrenergic agonists (bronchodilators)
• First line drug therapy
• Administered through a nebulizer or meter dosed inhaler
• Short acting agonists
o Albuterol (rescue inhaler)
▪ Can be administered through meter dose or
dry powder
▪ S/E
• Tachycardia
• Angina