2. Definition :- Asthma is an intermittent, reversible,
obstructive airway disease, it is
manifested by a narrowing of airway resulting in
dyspnea, cough and wheezing.
Asthma can begin at any age about half of the
cases develop in childhood and anther third
before age 40.
Asthma is often characterized as allergic,
idiopathic Or mixed
3. Exercise
Stress or emotional upset
Medications
Aspirin and non steroid anti-inflammatory chugs
(NSAlDs), beta-blockers (including eye drops),
cholinergic drugs (to promote bladder contraction and
as eye drops for glaucoma) .
Enzymes- including those in laundry detergents..
' Chemicals- toluene and others used in solvents,
paints, and plastics
4. The common symptoms of asthma are cough,
dyspnea & wheezing.
Asthma attacks frequently occur at
night.
Attacks starts suddenly with coughing
& a sensation of tightness in the
chest.
Cyanosis secondary to sever hypoxia.
Symptoms of carbon dioxide retention
- sweating, tachycardia.
5. Un Status asthmatics occurs in which therapeutic
measures fail &the
patient has repeated attacks or continuous asthma.
Allergic reaction eczema, urticaria, edema.
6. 1-Acomplete history.
2- Reaction skin test.
3-Assessment of environmental factors, including
seasonal changes, mold and pollens. Climate
changes.
4-Occupation- related chemicals & compounds
(metal salts, wood & vegetable dust,
pharmacological a gents, industrial chemicals,
biologic enzymes - including laundry detergents 5-
5-Chest X-ray.
6- Sputum examination.' Pulmonary function
studies
7. There are five categories of drugs used in the
treatment of asthma:
Beta antagonist brortchodilatots:eg pinephrine.
Methylxanthines - bronchodilator e.g aminophylline
Ant cholinergic - broncho-dilatition effect e.g. tropine.
Corticosteroids - reduce inflammation & broncho-
constrictione.g. hydrocortisone prednisone.5- Mast
cell inhibitors: broncho-dilatition g.cromolyn sodium.
8. Assessment :-ASSESS THE PATIENT RFOR :-
History of asthma onset & duration
Precipitating factors
Current medications
Medications used to relieve asthma symptoms
Any recent changes in medication regimen ,
Self-care methods used to relieve symptoms:
Assess General appearance.
Assess vital signs.
Assess laboratory findings.
9. Pneumonia is an inflammatory
illness of the lung. Frequently,
it is described as lung
parenchyma/alveolar
inflammation and abnormal
alveolar filling with fluid
10. Classification according to the causative
agent:
1-' Bacterial pneumonia (common *
streptococcus;)
2- Viral Pneumonia
3- Mycoplasma Pneumonia
4-Aspiration pneumonia's syndrome
5-Chemical pneumonia, after ingestion
of kerosene or irritation gases
11. Risk factor/groups:
Patients with conditions that produce
bronchial obstruction -
cancer
Immunosuppressed patients
Smokers
Bed ridden patients
Very ill patients who are on nothing by
mouth ,Over dose of sedatives- respiratory
depression
Associated with congestive heart failure
diabetes, alcoholism
13. A lobar pneumonia is an infection that
only involves a single lobe, or section, of a
lung. Lobar pneumonia is often due to
Streptococcus pneumonia (though
Klebsiella pneumonia is also possible.)
Multilobar pneumonia involves more
than one lobe, and it often causes a more
severe illness.
14. pneumonia by clinical
them into characteristics, dividing
1-"acute" (less than three weeks
duration) Streptococcus
pneumonia
2- "chronic" pneumonias.
15. is infectious pneumonia in a person who
has not recently been hospitalized.
Streptococcus pneumonia is
the most common cause of
community-acquired
pneumonia
16. called Nosocomial
pneumonia, is pneumonia
acquired during or after
hospitalization for another
illness or procedure with
onset at least 72 hrs after
admission.
17. risk factors for pneumonia,
including mechanical ventilation,
prolonged malnutrition, underlying
heart and lung diseases,
decreased amounts of stomach
acid, and immune disturbances.
18. 1- Pneumonia arises from aspiration of
flora present in the oropharynx. &
blood borne organisms that enter the
pulmonary circulation
2-An inflammatory reaction can occur
alveoli, producing exudates that in the
affect on ventilation 3-White blood
cells, mostly neutrophils, migrate into
the alveoli. Areas of the lung are not
adequately ventilated because of
secretions and mucosal edema that
cause partial occlusion of the bronchi
19. 4- Venous blood entering the
pulmonary circulation to the
left side of the heart poorly
oxygenated. The mixing of
oxygenated and unoxygenated
blood eventually results in
arterial hypoxemia.
20. Pneumonia
Clinical manifestations:
1-Cough producing greenish or yellow sputum,
2- high fever that may be accompanied by
shaking chills. 3- Shortness of breath4-
pleuritic chest pain, a sharp or stabbing pain,
either experienced during deep breaths or
coughs or worsened by them.
5- cough up blood, 6-headaches, or develop
sweaty and clammy skin.7- Other symptoms
are loss of appetite, fatigue, blueness of the
skin, nausea, vomiting, mood swings, and joint
pains or muscle aches.
21. 1-Medical intervention
Diagnosis:- patient's symptoms and
findings from physical examination,
chest X-ray and blood tests are
helpful, and sputum cultures chest CT
scan or other tests may be needed to
distinguish pneumonia from other
illnesses. A complete blood count
indicating the presence of an infection
or inflammation, in some people with
immune system problems
22. Management:
1-Administration of appropriate
antibiotics as Penicillin
Typically, oral antibiotics, rest,
fluids, and home care
2-people with other medical
problems and the elderly may need
treatment that is more advanced.
3-If the symptoms worse, the
pneumonia does not improve with
home treatment, or complications
occur, the person will often have to
be hospitalized.
23. Prevention
1-treating underlying illnesses (such as
AIDS)
2-Smoking cessation
3-Testing pregnant women for Group B
Streptococcus and Chlamydia trachomatis,
and then giving antibiotic treatment
4 Suctioning the mouth and throat of
infants with meconium-stained amniotic
fluid decreases the rate of aspiration
pneumonia.
5-Vaccination is important for preventing
pneumonia in both children and adults.
Vaccinations against Haemophilus
influenza and Streptococcus pneumonia in
the first year of life.
24. Assessment: .
The nurse should monitor the
-
following:
• Changes in temperature and pulse
• Amount, odor, and color of secretions
• Frequency and severity of cough
• Degree of Tachypnea or shortness of
breath
• Changes in physical assessment
findings (primarily assessed by
inspecting and auscultation the chest)
• Changes in the chest x-ray findings
25. NURSING DIAGNOSES
Based on the assessment data, the
patient’s major nursing diagnose smay
include: -
•1- Ineffective airway clearance related to
copious tracheobronchial secretions
•2- Activity intolerance related to impaired
respiratory function
• 3-Risk for deficient fluid volume related to
fever and dyspnea
• 4-Imbalanced nutrition: less than body
requirements
• 5-Deficient knowledge about the treatment
regimen and preventive health
26. Planning and Goals :-
The major goals for the patient may
include 1- improved airway
patency, rest to conserve energy,
2- maintenance of proper fluid
volume, maintenance of adequate
nutrition, 3- an understanding
treatment protocol and preventive
measures, 4- absence of
complications.
27. Nursing Interventions:-
1- IMPROVING AIRWAY PATENCY
2- PROMOTING REST AND CONSERVING
ENERGY.
3- PROMOTING FLUID INTAKE
4- MAINTAINING NUTRITION
5- PROMOTING THE PATIENT’S
KNOWLEDGE
6- MONITORING AND MANAGING
POTENTIAL COMPLICATIONS
7- PROMOTING HOME AND COMMUNITY-
BASED CARE &Teaching Patients
Self-Care.
28. EXPECTED PATIENT OUTCOMES
a -Has normal vital signs, pulse oximetry,
and arterial blood gas measurements
b. Reports productive cough that
diminishes over time
c. Has absence of signs or
symptoms of shock, respiratory failure, or
pleural effusion
d. Remains oriented and aware of
surroundings
e. Maintains or increases weight
8. Complies with treatment protocol and
prevention strategies.
