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  

a link with your classmates and friends in nursing  school. If you found value in this video, be sure  

and hit the like button, and leave a comment and  let us know what you found particularly helpful.