Asthma
Asthma is a chronic inflammation of the bronchial tubes (airways) that causes swelling and narrowing (constriction) of the airways. The result is difficulty breathing. The bronchial narrowing is usually either totally or at least partially reversible with treatments.
Bronchial tubes that are chronically inflamed may become overly sensitive to allergens (specific triggers) or irritants (nonspecific triggers). The airways may become "twitchy" and remain in a state of heightened sensitivity. This is called "bronchial hyperreactivity" (BHR). It is likely that there is a spectrum of bronchial hyperreactivity in all individuals. However, it is clear that asthmatics and allergic individuals (without apparent asthma) have a greater degree of bronchial hyperreactivity than nonasthmatic and nonallergic people. In sensitive individuals, the bronchial tubes are more likely to swell and constrict when exposed to triggers such as allergens, tobacco smoke, or exercise. Amongst asthmatics, some may have mild BHR and no symptoms while others may have severe BHR and chronic symptoms.(medicinenet.com)
Diagnosis for Bronchial Asthma
Because asthma does not always happen at the doctor's visit, it's important for you to describe your asthma signs and symptoms to your doctor. You might also notice when the symptoms occur such as during exercise, with a cold, or after smelling smoke. Asthma tests may include :
- Spirometry: A lung function test to measure your breathing capacity and how well you breathe. You will breathe into a device called a spirometer.
- Peak Expiratory Flow (PEF): Using a device called a peak flow meter, you forcefully exhale into the tube to measure the force of air you can expend out of your lungs. Peak flow monitoring can allow you to monitor your how well your asthma is doing at home.
- Chest X-Ray: Your doctor may do a chest X-ray to rule out any other diseases that may be causing similar symptoms.
Nursing Assessment for Asthma
- Cliet's Identity
- Past medical history: a history of heredity, allergies, dust, cold air.
- Health history now: complaints shortness of breath, cold sweat.
- Mental Status: weakness, fear, anxiety
- Breathing: changes in frequency, depth of respiration.
- Gastro intestinal: nausea, vomiting.
- The pattern of activity: body weakness, rapid fatigue.
- Physical examination
Chest- Contour, Confek, no defresi sternum
- Antero posterior diameter greater than the transverse diameter
- Structural abnormality Thorax
- Contour symmetrical chest
- Leather Thorax; Warm, dry, pale or not, the uneven distribution of color
- Respiratory rate and rhythm for one minute.
Palpation- Skin temperature
- Premitus: vibration in chest
- Development of chest
- Krepitasi
- Massa
- Edema
Auscultation- Vesicular
- Broncho vesicular
- Hyper ventilation
- Rochi
- Wheezing
- The location and changes in breathing and when they arise.
- Investigations
- Spirometry: To show the existence of airway obstruction.
- Provocation test:
- To support the existence of bronchial hyperactivity.
- Provocation tests done if not done through spirometry test.
- Bronchial provocation tests
To support the bronchial hyperactivity, provocation tests done if not performed spirometry test. Bronchial provocation tests such as histamine provocation test, metakolin, allergens, physical activity, hyperventilation with cold air and inhaled by aqua destilata.
- Skin test: To show the existence of antibodies specific IgE in the body.
- Examination of total IgE levels with specific IgE in serum.
- Radiological examination is generally normal chest X-ray images.
- Blood gas analysis performed on severe asthma.
- Examination of total eosinophils in the blood.
- Examination of sputum.
Nursing Assessment for Asthma