care plan

care plan

hey guys. this is jon with 2-minute rn from nrsng.com. today, we re gonna talk about asthma. okay. so, let s get into it real quick. asthma, is basically chronic inflammationof the airways which leads to intermittent obstruction. this can be due to allergens, sinusitis, coldand dry air, medications, food additives, hormones, and basically allergies to differentthings.

so, what can happen is, if the patient becomesunresponsive to treatment, if the airways becomes unresponsive to treatment, then thiscould actually lead to status asthmaticus, which is a very emergent situation. okay, so, let s talk really quick about assessmentfindings. if you have a patient who comes in complainingof asthma, some of the things that you re gonna see are you gonna see dyspnea, or beingshort of breath. you re gonna hear wheezing on expiration. so, if the patient is just wheezing air when they’re exhaling air, that’s a good sign that it could be asthma,

just a (wheezing sound) kinda wheezing sound like that when they expire. they’re gonna complain of chest tightness. they re gonnahave tachypnea which is breathing very fast and being short of breath. they re gonna havediminished breath sounds. okay. they re gonna have this airways full of mucus, that theyre gonna have a hard time, you re gonna have hard time hearing the breath. they re gonnahave decreased pao2, partial pressure of oxygen, and so you may see respiratory alkalosis.okay, what does that mean? well, alkalosis, you re gonna have your ph just gonna be above7.45. with ph of above 7.45, that means our o2 of course is gonna be lower. so, with that,as well, you know, your co2 is gonna be lower. to manage this, what are we gonna do? we regonna give medications to manage it. okay,

so, some of the meds that we re gonna give,are gonna be beta agonists. some of the beta agonists are gonna be bronchodilators, anticholinergics,and theophylline. theophylline is a medication, it is not given very often nowadays, so wewon t talk about it much, but maybe we ll get into that a little bit later. bronchodilators,of course, are gonna expand the airways, open them up and you should always give bronchodilatorsbefore other meds. okay. why? because as we give those bronchodilators, we re gonna expandthe airways and that s gonna allow things like our corticosteroids, our anti-inflammatoryand our o2 to actually get into there. okay, so, other things you re wanna do, you re wannawant to identify precipitating factors, you re gonna ask the patient where they work,if they ever had allergies before, if they

ever experienced chest tightness when theyre outside or in specific seasons, etc. you gonna wanna teach proper inhaler use. forexample, you wanna teach the patient to take deep breaths to ensure the medication getsin. they re gonna wanna shake the inhaler up before they take it. and they re gonnawanna allow, once they inhale the medication. they re gonna wanna hold their breath firstas long as they can, in about 10 seconds to allow the medication to distribute throughoutthe lungs. they re gonna teach patients about peak-flow meter, this is a device they cantake at home and they can kinda monitor their own asthma reactions. so, peak flow meters,they re gonna wanna achieve 80% - 100% of their peak amount. and, that s something theycan do at home to kinda determine if they

re experiencing exacerbations of asthma. let s look at the normal bronchioles. youre gonna have, notice that you have a lot of space here for the air to get in. whathappens with asthma, this becomes closed in, and they have less space for air to get in.and that can be due to excessive mucus you can see swelling from allergens and thingslike that. this can be very intimidating and terrifying to patients because they are notable to breath. it becomes very very scary to them. this is just a little picture ofan inhaler. a lot of asthma medications are given, especially for kids and things, aregiven via nebulizer. the reason for the nebulizer type things, this is an inhaler, not necessarilya nebulizer, but giving it in this form allows

it to get more into the lungs. okay, someof the medications that you re gonna see are gonna be the different brochodilators, albuterol,things like that, spiriva, and then you re gonna see montelukast, things like that. thoseare gonna be the medications that you re gonna see most often with these patients. alright, that s the quick overview of asthma.check out more and be sure to subscribe to get all the 2-minute rn videos. thank you.

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