Hi, I'm Cathy with Level Up RN. In this video, we are going to talk about asthma. And at the end
of the video, I'm going to give you guys a quick little quiz to test your knowledge of some of the
facts I'll be covering in this video. And if you haven't already done so, I invite you to subscribe
to our channel because we have hundreds of free videos to help nursing students and nurses.
Okay. Let's talk about asthma. Asthma is a chronic inflammatory disorder of the airway.
It is intermittent and reversible. So this is differentiated from COPD, which I'll talk about
in my next video, which is not reversible. So the pathophysiology behind asthma is that
we have a trigger, so it could be an allergen or it could be cold air, and it causes inflammation
and airway hyperresponsiveness which in turn causes bronchoconstriction and airway
obstruction. So signs and symptoms of asthma include dyspnea, so difficulty breathing,
wheezing, chest tightness, coughing, tachypnea, use of accessory muscles, prolonged expiration.
And then with severe and prolonged asthma, some patients may present with a barrel chest.
In terms of how we diagnose asthma. We would perform pulmonary function tests, so PFTs.
We can also run ABGs, so arterial blood gases. The patients SpO2 may be decreased with an ABG.
Also, the patient may have a decreased oxygen saturation. So their SpO2 may be below 92%.
Now let's talk about the treatment of asthma. Your patient with asthma will be prescribed
bronchodilators. So this will include control therapy as well as reliever drugs,
and we'll talk more about that in a minute. In addition, they may be prescribed anticholinergics,
anti-inflammatories, and leukotriene antagonists. So there's a number of teaching points that you're
going to want to provide your patient with asthma. They should keep tabs on their asthma using a
peak flow meter. So the peak flow meter will alert them to airway narrowing before they even
have symptoms. So if they get that alert like your airways are possibly in trouble, they can
take their reliever drug to kind of head off any issues. So when they use their peak flow meter,
they need to use it three times and record the highest number out of those three attempts.
Not the average number. You also want to counsel your patient to identify and avoid environmental
triggers as well as irritants. And then for exercise-induced
asthma, they should take their bronchodilator 30 minutes before they're going to exercise. And then
you want to educate your patient on the difference between their short-acting asthma medication and
their long-acting asthma medication. So albuterol is a short-acting bronchodilator and that's what
we would use as a reliever drug. So albuterol is for acute asthma attacks, so we have all A's
there. And then salmeterol is a long-acting bronchodilator and it is used as a control
therapy, so the patient would take it daily and this helps with long-term control of asthma.
So you definitely need your patient to know the difference between those two medications,
and it's going to be important for you to know that as well as the nurse. And then lastly,
you want to advise your patient to always carry an emergency inhaler with them wherever they go.
A life threatening complication of asthma is status asthmaticus which is airway obstruction
that is unresponsive to usual therapy, and it can lead to a pneumothorax as well as cardiac
and respiratory arrest. Signs and symptoms of status asthmaticus can include extremely labored
breathing, gasping or inability to speak, decreased level of consciousness, cyanosis,
neck vein distention, and something called pulsus paradoxus which is a decrease in
systolic blood pressure during inspiration. So treatment of status asthmaticus will include
bronchodilators, epinephrine, and corticosteroids. As the nurse, you're going to administer oxygen
and prepare the patient for emergency intubation and mechanical ventilation.
Okay. Time for a quiz. I have three questions for you. First question. Prolonged expiration
is a symptom of asthma. True or false? The answer is true. Second question. When using a peak flow
meter, your patient should record the average number after three attempts. True or false?
The answer is false. They should record the highest number after three attempts.
Question number three. What type of bronchodilator
should your patient use as a reliever drug during an acute asthma attack?
The answer is a short-acting bronchodilator such as albuterol. So hopefully you did well on that
quiz. If not, definitely go back and review our flashcards or watch the video again. I hope this
helped a bunch. Take care and good luck studying. I invite you to subscribe to our channel and share
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