Resources For Asthma Patients
At Mass General Brigham Asthma Center, we believe that the more patients and their families know about asthma, the better able they are to care for their illness and prevent serious asthmatic exacerbations.
Our Asthma Center has developed a large body of information about asthma for our patients to read, and we make this information available on-line for the general public. It includes a series of pamphlets on basic topics in asthma, and a small, introductory book about asthma, called Asthma Centers Guide to Asthma . A book written by our Asthma Center faculty, called the Harvard Medical School Guide to Taking Control of Asthma, was published and is available at on-line booksellers.
Please contact us for a copy of the Asthma Centers Guide to Asthma.
Nursing Interventions With Rationales For Bronchial Asthma Anxiety
| Nursing Interventions | |
| Stay with the patient and encourage slow, deep breaths. | Consistent presence and coaching can help lessen feelings of anxiety during an asthma exacerbation. |
| Provide a calm environment and decrease stimuli. | A calm environment will decrease anxiety, thus decreasing oxygen consumption. |
| Educate the patient on pursed-lip breathing. | Pursed lip breathing is an intentional breathing technique that encourages slow, deep, effective breaths. |
| Help the patient develop an emergency plan for asthma attacks. | The patient should always have their rescue inhaler on hand. During an asthma exacerbation, the patient should sit upright and administer their rescue inhaler. If no relief is felt within 4 minutes, the patient should seek immediate medical attention, and continue administering the rescue inhaler every 4 minutes. |
Nursing interventions with rationales for Asthma Anxiety
Nursing Interventions With Rationales For Bronchial Asthma Knowledge Deficit
| Nursing Interventions | Rationales |
| Educate the patient about rescue inhalers vs. controller inhalers. | Rescue inhalers are meant to be used in case of emergency and should not be used every day. Controller or maintenance inhalers can be used every day to decrease symptoms of asthma. Examples of maintenance inhalers are Symbicort and Advair. |
| Educate the patient about environmental asthma triggers. | Examples of environmental triggers include smoke, allergens, mold, and air pollution. |
| Educate the patient on how to effectively manage asthma when exercising. | Sometimes asthma can be exacerbated by exercise. Walking, swimming, or hiking are asthma-friendly alternatives, and exercise with short bursts of activity is better than prolonged exercise. Sometimes a physician can prescribe a rescue inhaler to be used before exercise. |
| Show the patient how to use a spacer. | A spacer is a tube between the inhaler and the patients mouth which gives the patient more time to inhale the medication. |
| Advise the patient to rinse their mouth following administration of an inhaled corticosteroid. | If the mouth is not properly rinsed after administration of inhaled corticosteroids the patient can develop thrush, a fungal infection in the mouth, which looks like white patches on the mucous membranes and tongue. |
Nursing interventions with rationales for Asthma Knowledge deficit
Recommended Readings & References
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Promoting Asthma Control In Children
Purchase hardcopyAbout this Guideline
This best practice guideline focuses on assisting nurses working in diverse practice settings in providing basic asthma care for children and their families.
The goal of this document is to promote asthma control in children, from infancy through to 18 years of age.
Nurses, working in partnership with the multidisciplinary health care team, have an important role in promoting the control of asthma in children through key interventions of assessment, education and referral across diverse contexts and settings. This guideline focuses on children who have a diagnosis of asthma along with their families, and includes recommendations for developmentally appropriate assessment, management, education, referral and follow-up. For simplicity throughout the document, the word child or children will be used to refer to individual from birth to 18 years of age. For individuals 18 years of age and older, refer to the RNAO nursing best practice guideline Adult Asthma Care Guidelines for Nurses: Promoting Control of Asthma .
Supplement: 2008
Nursing Care Plan For Asthma 5
Health-Seeking Behaviors: Prevention of Asthma Attack
Nursing Diagnosis: Health-Seeking Behaviors: Prevention of Asthma Attack related to an expressed desire to avoid and correct situations impetus of asthmatic episodes, as evidenced by an increased interest for better control over health practices, the impact of environmental factors and behavioral factors on health, and an increase in the number of attacks
Desired Outcomes:
- The parents and the patient will communicate their comprehension of the triggering agents that may induce an asthma attack.
- Avoidance strategies will also be communicated effectively.
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How Do You Test For Asthma
There are many ways to test asthma, but the most accurate way is with spirometry or peak flow. Spirometry assesses how much air is inhaled and exhaled in a specific amount of time, while peak flow monitors lung function by measuring the speed at which air leaves your lungs during a forced breath. The two methods work together to provide information about how well your lungs are functioning and can be used as part of an overall treatment plan for asthma.
To accurately monitor lung function with either method, you must follow all instructions carefully and use your best effort when taking the measurement.
Spirometry or peak flow will help identify asthma because it measures how well you can move air through your lungs by measuring the volume and the speed with which you exhale . There are many reasons for wheezing that may not be related to asthma, so if your doctor suspects asthma, they will need more tests such as a lung function test called spirometry or peak flow test.
Spirometry measures the amount of air you can exhale in one second, while peak flow measurement records how much air you can blow out in one breath. Peak flow readings are typically assessed by blowing into an asthma-management device called a peak flow meter which usually displays your reading as millimetres of mercury . The higher the number on the meter reading, the better your airflow is likely to be.
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Asthma Education For Pediatric Patients
Whats a nurse to do without an asthma educator?
CNE 1.5 contactHours
1. Identify triggers associated with asthma.
2. Discuss medications used to manage asthma.
3. Describe strategies for educating children with asthma and their families and caregivers.
The authors and planners of this CNE activity have disclosed no relevant financial relationships with any commercial companies pertaining to this activity. See the last page of the article to learn how to earn CNE credit.
Expiration: 8/1/23
Takeaways
- Asthma is not curable, but it is controllable, and requires disease knowledge and understanding, which is gained through proper education.
- In the absence of an asthma educator, nurses need a general understanding of the basics of asthma to provide patient education.
- Medication administration is a major factor in asthma control.
Asthma, a chronic condition that leads to significant morbidity and mortality, affects 24.6 million people in the United States 6.2 million of those are children. These numbers make asthma control a top priority for healthcare providers. According to the National Heart, Lung, and Blood Institutes National Asthma Education and Prevention Program Expert Panel Report 3 , Guidelines for the Diagnosis and Management of Asthma, comprehensive patient, family, and community education is crucial to disease management.
Download a visual abstract of this continuing nursing education article to share on social media, here. Be sure to tag us on , , and !
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Resources For Best Practices In Asthma Patient Care
1. National Guidelines for Asthma Patient Care:
- Allergy & Asthma Network: Courses for health care professionalsincluding resources about disparities in asthma.
- National Jewish Medical and Research Center: Current professional education opportunities on asthma and other respiratory conditions
- US Centers for Disease Control: ATSDR Case Studies in Environmental Medicine: Environmental Triggers of Asthma illustrates environmental exposures to allergens, air pollutants, environmental tobacco smoke and workplace exposures that both cause and exacerbate asthma
- National Environmental Education Foundation Pediatric Asthma Initiative designed environmental questionnaires to administer to asthma patients.
- National Asthma Educator Certification Board the NAECB exam is a voluntary testing program used to assess qualifiedhealth professionals’ knowledge in asthma education.
Learn More Through Online Courses
- Ozone and Your Patients’ Health: Created by EPA, this short, evidence-based training course is designed for medical professionals who counsel patients about asthma and respiratory symptoms, including family practice doctors, pediatricians, nurse practitioners, and asthma educators.
- Cover of brochure showing air pollutants’ effects on the lungs Particle Pollution and Your Patients’ Health: Created by EPA and CDC, this course discusses the extensive body of scientific evidence showing that exposure to particle pollution may lead to a range of adverse health effects, including effects on the heart, lungs, and cardiovascular system, as well as premature death. It also provides educational materials to help patients understand how particle pollution can affect their health and how to use the Air Quality Index to reduce risk. CDC provides free continuing education credit for the course for doctors, nurses and health educators.
- Case Studies in Environmental Medicine Environmental Triggers of Asthma: Created by the Agency for Toxic Substances and Disease Registry , this course is to designed to increase the primary care provider’s knowledge of hazardous substances in the environment and to promote the adoption of medical practices that aid in the evaluation and care of potentially exposed patients. The case studies provided in this tutorial focus on environmental triggers of asthma.
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What To Do If The School Will Not Work With You
Public or private schools that get funds from the federal government have to follow Section 504 and the ADA. Public schools must provide a free and appropriate education in the least restrictive environment.6
Also, all non-religious private schools must abide by the ADA, regardless if they receive federal funding. While they do not have to provide a free and appropriate education, private schools are public accommodations under the ADA, and therefore have to take necessary steps to make sure a child is not excluded, denied services, or treated differently due to their disability .7 As a recent agreement with the Department of Justice indicated, these obligations can include the requirements to administer emergency medicine such as epinephrine auto-injectors.
If a public school is not willing to accommodate your child, contact your school districts superintendent or 504 coordinator in writing. If you continue to be unhappy with the plan as implemented by the school district, you can contact the Department of Educationâs Office for Civil Rights or file a suit in a federal court.3
Causes Of Copd Chronic Obstructive Pulmonary Disease
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National Environmental Education Foundation
Environmental Management of Pediatric Asthma These guidelines for health care providers focus on integrating environmental management of asthma into pediatric health care. The guidelines outline competencies in environmental health relevant to pediatric asthma that should be integrated into routine asthma care by health care providers. The guidelines also provide details about environmental intervention recommendations that should be shared with patients as part of a clinical asthma visit.
Resources For Parents Caregivers And Kids
Find tips on keeping a smoke-free home and car on EPA’s Smoke-Free Homes website.
It’s hard to see a child sick. The good news is you can help a child gain control over asthma. That means fewer days out of school and fewer attacks that can be scary for you and the child.
Along with the doctor, you have an important role in helping a child control asthma.
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Asthma Nursing Care Plan For A Client In Status Asthmaticus:
1) Maintain patent airway, and frequently assess for change in mental status.
2) Administer Albuterol 2.5mg every 12 hours by nebulizer through a spacer. If wheezing persists, administer Albuterol every 5 minutes by nebulizer with the client sitting position on bed rest.
3) Administer oxygen by nasal cannula at 8-10L/min or via facemask at 15L/ min.
4) Place an IV and infuse fluids at a rate of 50mL/kg/hr.
5) If the client is hypotensive, administer IV epinephrine 0.1 to 0.5 mcg/kg every 5 minutes as needed for systolic BP less than 90mmHg or diastolic less than 60mmHg.
6) Administer Diphenhydramine HCl every 4 to 6 hours PRN.
7) Consider IV magnesium sulphate with at least two additional drugs if significant tachycardia persists despite other interventions or if hypotension is present.
8. Auscultate breath sounds every 4 hours and report dyspnea, rales, or crackles to a physician.
9) Assess vital signs hourly for changes and notify the physician if necessary.
Develop An Asthma Action Plan
Ask your doctor to help you create an asthma action plan for your child that will help you learn to prevent your child’s asthma attacks. You can order copies or download sample asthma action plans from the following places.
- Public Health Institute: Available in English, Spanish, Vietnamese, and Chinese.
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Treatment For Shortness Of Breath
Asthma Center Grand Rounds Podcast
You may subscribe to podcasts of Mass General Brighams Asthma Center Grand Rounds presentations on Apple Podcasts.
Archived presentations which may be available upon request include:
- Obesity and Asthma: Curiosity or Causalityby Dr. Kelan Tantisira
- Churg-Strauss Syndrome: A Clinical Updateby Dr. Michael Wechsler
- Asthma Outcomes: How We Choose the Right Measure?by Dr. Anne Fuhlbrigge
- Beta-Agonists: Our Response is in Our Genesby Dr. Elliot Israel
- Pro-Con Debate: Inhaled Steroids are Safe, Even in Very Young Children
- Pro Position: Resolved: Inhaled Corticosteroids Should Be First Line Therapy for Asthma in Childrenby Dr. Henry Dorkin
- Con Position: Steroids at a Price?by Dr. Bernard Kinane
- The Ins and Outs of T cell Trafficking in Asthma:by Dr. Andrew D. Luster
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Asthma Grand Rounds Schedule: 2021
CME credit
Harvard Medical School is accredited by the Accreditation Council for Continuing Medical Education to provide continuing education for physicians. Harvard Medical School designates this educational activity for a maximum of 1 PRA category 1 creditTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Live webcasting
Asthma Grand Rounds are made available via live webcasting at your computer terminal or tablet here.
What Are The Signs And Symptoms Of Mild And Moderate Intermittent Asthma
Asthma symptoms can range from mild to life-threatening, depending on how often you have asthma attacks, what triggers them, and your reaction to the triggers.
Mild symptoms include coughing, wheezing, breath sounds, difficulty breathing, absence of dyspnea, and no need to use the reliever inhaler.
Moderate symptoms include coughing, wheezing, difficulty in breathing with small amounts of sputum .
Signs of severe asthma are coughing, dyspnea, wheezing, blue or gray lips with feeling like you are not getting enough air in your lungs. You may also have chest tightness, trouble breathing even lying down, and an inability to speak or walk.
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Signs And Symptoms Of Asthma Attacks
- Non-stop coughing
- Severe wheezing
- Rapid breathing
- Retractions tightened neck and chest muscles
- Difficulty talking
- Feelings of anxiety or panic
- Pale, sweaty face
- Cyanosis blue lips or fingernails
Asthma may be worsening if the patient experiences the signs and symptoms or has asthma attacks more frequently.
He/she may have more shortness of breath based on peak flow meter readings and may have to alleviate the symptoms using a quick-relief inhaler more frequently than usual.