Asthma Education Program

Asthma affects approximately 300 million people (Dharmage et al., ). Asthma is a common childhood disease. Common symptoms are wheezing and cough. Patients also experience shortness of breath. Chest tightness and pain are common. Recurrent respiratory infections may signal asthma.

Pathophysiology

• Inflammation determines the degree of severity (Dharmage et al., 2019).
• Allergic reactions are important environmental factors.
• Disease onset occurs early in life.
• Airway inflammation is the first step.
• Intermittent airflow obstruction limits breathing capacity (Dharmage et al., 2019).
• Bronchial hyperesponsiveness impedes airflow in patients.

Differential Diagnoses

• Some illnesses mimic acute asthmatic attacks.
• Inducible laryngeal obstruction inhibits normal airflow.
• Bronchial and tracheal lesions cause distress. (The National Institute for Health and Care Excellence (NICE), 2017).
• Aspirated foreign bodies may cause wheezing.
• Congestive heart failure causes breathing difficulties.
• Aortic arch anomalies mimic exercise-induce asthma.

Common Causes

• Environmental allergens such as dust mites.
• Viral respiratory tract illnesses and sinusitis.
• Hypersensitivity to medications such as aspirin.
• Emotional factors such as stressful situations (Gautier & Charpin, 2017).
• Certain low-molecular and high-molecular environmental substances.
• Perinatal factors such as low birth-weight (NICE, 2017).

Uncommon Causes

• Gastroesophageal reflux disease sometimes causes asthma.
• Exercise-induced asthma occurs in susceptible individuals.
• Abnormal lipid metabolism may cause asthma.
• Occupational exposure to toxins and chemicals (Gautier & Charpin, 2017).
• Severe beta-adrenergic receptor blocker hypersensitivity reactions.
• Household irritants such as scented candles.

Asthma Classification

• Intermittent asthma commonly varies in severity.
• Mild persistent asthma affects personal activity.
• Moderate persistent asthma has nighttime symptoms.
• It causes daily cough and wheezing.
• Severe persistent asthma causes continued symptoms.
• It causes severe frequent nighttime symptoms.

Diagnosis

• Blood and sputum eosinophil level evaluation (NICE), 2017).
• Pulse oximetry testing of suspected cases.
• Assessment of affected individuals’ chest radiographs.
• Allergy skin testing in atopic patients.
• Peak expiratory flow monitoring in emergencies (NICE), 2017).
• Pulmonary function tests such as spirometry (NICE), 2017).

Complications

• The disruption of daily life activities.
• Patients are unable to sleep adequately.
• Attacks may cause frequent hospital admissions.
• Chronic asthma leads to airway remodeling.
• Severe attacks may cause respiratory failure.
• Medically induced effects include weight gain.

Treatment: Quick Relief

• Quick relief medicines relieve acute exacerbations.
• They are commonly called reliever medications.
• They help alleviate acute asthma symptoms.
• They include short-acting beta agonist drugs (NICE, 2017).
• Others include anticholinergics for severe cases.
• Systemic steroids help speed up recovery (Papi et al., 2020).

Treatment: Long-Term Control

• Long-term control facilitates limited acute attacks (Papi et al., 2020).
• Various drugs are combined for synergy.
• Inhaled corticosteroids are ideal chronic medications (NICE, 2017).
• However, they may retard infant growth.
• Long-acting beta agonists are effective agents.
• Others include leukotriene agonists and methylxanthines (NICE, 2017).

Stepwise Management

1. Step1: Reliever medication for symptoms.
2. Step 2: Administer low-dose inhaled cortecosteroids (Dunn et al., 2017).
3. Step 3: Inhaled corticosteroid and beta-agonist (Dunn et al., 2017).
4. Step 4: Medium –dose corticostroid and beta-agonist.
5. Step 5: High-dose corticosteroid and beta-agonist (Dunn et al., 2017).
6. Step 6: High-dose corticosteroid and beta-agonist.

Prevention

• Controlling exposure to dangerous occupational irritants (Dunn et al., 2017).
• Self-management based on asthma disease facts.
• Developing effective school-based asthma education programs.
• Screening susceptible individuals for the disease (Dunn et al., 2017).
• Ensuring atopic individuals avoid known irritants.
• Effectively treating recurrent respiratory tract infections.

References

Belleza, M. (2021). Asthma nursing care management and study guide. Nurselabs.

Dharmage, S. C., Perret, J. L., & Custovic, A. (2019). Epidemiology of asthma in children and adults. Frontiers in Pediatrics, 7(246), 1–15.

Dunn, N. A., Neff, L. A., & Maurer, D. M. (2017). A stepwise approach to pediatric asthma. Journal of Family Practice, 66(5), 280–286.

Gautier, C., & Charpin, D. (2017). Environmental triggers and avoidance in the management of asthma. Journal of Asthma and Allergy, 10, 47–56.

Papi, A., Blasi, F., Canonica, G. W., Morandi, L., Richeldi, L., & Rossi, A. (2020). Treatment strategies for asthma: Reshaping the concept of asthma management. Allergy, Asthma and Clinical Immunology, 16(1), 1–11.

Porsbjerg, C., Ulrik, C., Skjold, T., Backer, V., Laerum, B., Lehman, S., Janson, C., Sandstrøm, T., Bjermer, L., Dahlen, B., Lundbäck, B., Ludviksdottir, D., Björnsdóttir, U., Altraja, A., Lehtimäki, L., Kauppi, P., Karjalainen, J., & Kankaanranta, H. (2018). Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults. European Clinical Respiratory Journal, 5(1) 1-21.

The National Institute for Health and Care Excellence (NICE). (2017). Asthma: Diagnosis, monitoring and chronic asthma management. NICE Guidance, 1–38.