Bronchial Asthma

what is Bronchial Asthma

Intermittent & reversible airflow obstruction affecting the lower airways

Etiology (Causes)

Inflammation triggers: allergens, cold air
Bronchospasm triggers: exercise

Physical Assessment Findings – “WHEEZE”

Wheezing (louder on exhalation)

Hypoxemia (cyanosis, ↓ O₂ sat)

Elevated RR (tachypnea)

Exertional dyspnea (SOB)

Zero airflow (severe attack → silent chest = emergency)

Extra accessory muscle use

Nursing Goals – “AIR”

Airflow improvement

Inhaler teaching & trigger avoidance

Relieve symptoms / prevent attacks

Laboratory Assessment: “A I-PERFECT

A – ABG (check O₂ ↓, CO₂ ↑ in severe asthma)

I – IgE ↑ (allergy marker)

P – Pulmonary Function Tests (most accurate test)

E – Eosinophils ↑ (allergic response)

R – Reversibility test (≥12% improvement with bronchodilator)

F – FVC (forced vital capacity)

E – FEV1 (forced expiratory volume in 1 sec)

C – Challenge test (Methacholine) induces bronchospasm, then recheck values

T – Top flow (PERF) – peak expiratory flow rate

Client Education Guide

• Avoid asthma triggers

• Use bronchodilator 30 min before exercise

• Correct technique for metered-dose inhalers (MDI)

• Adequate rest, stress reduction, relaxation techniques

• If meds fail to control symptoms → seek emergency care

Asthma Drugs – “BAM” (for bronchodilators)

• Beta₂ agonists (Albuterol, Salmeterol)

• Anticholinergics (Ipratropium)

• Methylxanthines (Theophylline)

Asthma Drugs: “SCRAM” (for anti-inflammatory)

• Steroids (Prednisone, Fluticasone)

• Cromolyn sodium (mast cell stabilizer)

• Reslizumab / Omalizumab (monoclonal antibodies)

• Anti-IgE therapy

• Maintenance meds (not for acute attacks)

.Exercise/Activity & Oxygen Therapy

Aerobic exercise (esp. swimming) → improves cardiac health, muscle strength, ventilation & perfusion