Asthma nursing care and management

Nursing - Asthma

The limitation of airflow in asthma is reported as "recurrent and caused by a variety of changes in the airway." (Expert Panel Report 3, National Heart, Lung, and Blood Institute, 2007, p.1) Those changes include: (1) bronchoconstriction; (2) airway edema; (3) airway hyperresponsiveness; and (4) airway remodeling. Expert Panel Report 3, National Heart, Lung, and Blood Institute, 2007, p.1) Airway edema occurs with the progression of the disease and the inflammation is more progressive and exacerbated by "edema, inflammation, mucus hypersecretion and the formation of inspissated mucus plugs as well as structural changes including hypertrophy and hyperplasia of the airway smooth muscle." (Expert Panel Report 3, National Heart, Lung, and Blood Institute, 2007, p.1) Airway hyperresponsivenss is reported to be "an exaggerated bronchoconstrictor response to a wide variety of stimuli. Airway modeling speaks of the permanent structural changes in the airway reported to be associated with "loss of lung function that is not prevented by or fully reversible by the current therapy." (Expert Panel Report 3, National Heart, Lung, and Blood Institute, 2007, p.1)

Pathophysiology of Chronic Asthma

Factors that limit airway flow in acute and persistent asthma include environmental factors and inflammatory products. Airway narrowing and the following interference with airflow are the clinical symptoms in the physiological event. Allergen-inducted acute bronchorestriction is stated to result from "IgE-dependent release of mediators from mast cells that includes histamine, tryptase, leukotrienes, and prostaglandins that directly contract airway smooth muscle." (Expert Panel Report 3, National Heart, Lung, and Blood Institute, 2007, p.1)

Pathophysiology of Acute Asthma Exacerbation

Bronchial smooth muscle contraction is reported to occur quickly in acute exacerbations of asthma and narrows the airways in response to exposure to various stimuli stated to be inclusive of "allergens or irritants." Expert Panel Report 3, National Heart, Lung, and Blood Institute, 2007, p.11) Also known to cause acute airflow obstruction is aspirin and other nonsteriodal anti-inflammatory drugs. Other stimuli that can cause acute airflow obstruction are cold air, irritants and exercise since the mechanisms that regulate the response of the airway to these factors are not well defined however, due to the intensity of the response is believed to be related to airway inflammation. Stress is also known to exacerbate asthma.

Genetics Impact on Pathophysiology of Chronic Asthma and Acute Asthma Exacerbation