#asthmaattacks

Asthma is a common disorder which occurs in both children and adults. During an attack there is a temporary spasm of the breathing tubes, that is, they contract suddenly and involuntarily so that the patient finds it hard to breathe. In between attacks, which can be distressing, the breathing may be perfectly normal. Asthma does not cause any permanent damage to the heart or lungs.

Definition

Asthma is a chronic inflammatory disease of airways that cause airway narrow and swell and hyper-responsiveness of bronchospasm and overproduction of mucus. This swelling or inflammation makes the airways hyper-sensitive and increases the risk of allergic reaction. Asthma is an incurable disease of the airways, which causes inflammation and narrowing inside the lungs and tightens the muscles that control the airways, in result supply of air becomes difficult. According to a research, in the United States around 8.3 percent of people have a form of asthma, while worldwide 250,000 people die every year due to asthma.

Causes / Aetiology

It’s not clear why some people get asthma and others don’t but following are some factors which are responsible for asthma. Environmental factorsChange in temperature mostly cold airChange in humidity of dry airAtmospheric PollutantsCigarette, industrial smoke, ozone, Sulphur dioxide, formaldehyde. Allergen inhalation Food treated with sulphate, beer, wine etc.Stress / Emotional upsetMedication NSAIDs, B-blockersStrong odors and perfumes

Sign and Symptoms

Asthma cannot be cured, but its symptoms can be controlled as they vary person to person and often change over time. It is important that you work with your doctor to control your signs and symptoms, because you may have infrequent asthma attacks or have symptoms only at certain times. Asthma signs and symptoms include:Wheezing (a whistling sound when exhaling)Cough (all night and early morning)Chest tightness or painShortness of breath, coughing or wheezing specially at sleep timeDyspnea (breathlessness) Ronchi (sound during inspiration)

Types of Asthma

There are many different types of Asthma, separated by age and severity. If you have been diagnosed with asthma, it’s important to understand which type you have, it can help you understand how to manage it. Extrinsic (Allergic Asthma) Allergic asthma triggers by allergens like pollen, pets and dust mites. About 80% of people with allergic asthma suffers with hay fever, eczema or food allergies.If you have allergic asthma your doctor will prescribe a preventer inhaler to take every day and a reliever inhaler at the time of asthma attack. Allergic asthma mostly occurs in childhood. According to the American Lung Association between 400,000 and 1 million children experience severe asthma symptoms. Mild asthma might resolve without treatment during childhood as they get older. However, it is possible that the condition might return later on if it’s moderate or severe. Intrinsic (Non-allergic) Non-allergic asthma does not trigger like pollen or dust, commonly occurs about 35 years of age and is less common than allergic asthma. This type of asthma is often persistent and requires the daily management of flare-ups and preventing symptoms. Obesity is a strong risk factor of this type of asthma and women are more likely to develop it after the age of 20 years. Seasonal Asthma Some people experience the asthma that only flares up at certain times of the year, like during hay fever season or when it’s cold. If you have been diagnosed with seasonal asthma, you might only need to take your medicine during the season and for a short time afterwards.

Asthma Attacks

The inflammation in respiratory system can lead to a severe asthma attack. Asthma attacks occur when symptoms are at their peak, might begin suddenly or from mild to severe. This type of asthma attacks can be dangerous and require urgent hospitalization. At the start of an asthma attack nor the enough air go into the lungs, nor the carbon dioxide leave the lungs at fast. Carbon dioxide is poisonous if the body does not throw out the gas. In prolonged asthma attacks lungs fill with gas and oxygen cannot enter the bloodstream in enough amount. Around 12 percent of people face difficulties to control asthma and 5 percent do not see improvements after using the standard medications in severe asthma. While with the correct medication and effective trigger avoidance, asthma symptoms can be under control.

Prevention

There is no way to prevent asthma, but by working together, you and your doctor can design a plan for better living. Write a detailed plan for taking medications with the help of your doctor to manage your asthma and strictly follow that action plan.Get vaccinated for influenza and pneumonia that triggers asthma flare-ups.Find out what causes and triggers worse your asthma, and try to avoid them.Regularly monitor and record your breathing with a home peak flow meter.If you identify and treat attacks early, you are less likely to have a severe attack.Take your medication as prescribed and don’t change anything without consulting to your doctor.Talk to your doctor to increase quick-relief inhaler use.

Diagnostic Evaluation

Physical examination History collectionSpirometry ABG (atrial blood gas analysis), hypoxemia, increased acidosisChest X-ray for hyperinflation of lungsAuscultation of breath sound

Complications

Respiratory failureAsthmaticusPneumonia Atelectasis (collapse of lungs)Cardiac arrest

Nursing Management

The nurse generally performs the following assistance. Assesses clinical signs of airway distress of patient.If it is acute airway distress she will give emergency management. Takes a history of patient.Collects knowledge about allergic reaction in different environmental conditions.Asks about working place and life style.Provides psychological support to the patient.Assesses respiratory rate and breath pattern and depth.Gives fowler position to the patient.Provides bronchodilator and steroids.Gives suctioning if airway obstruct.Monitors sputum for colour and consistency.Gives oral hygiene in every 2-4 hours.Assesses lung sounds in every hour for determine gas exchange.Assesses colour of mucous membrane or skin for detection of cyanosis.

Medical Management