According to "Sheehy's Emergency Nursing Principles and Practice," asthma is an obstructive disease of the lungs that can be controlled but not cured. It has an unpredictable course that can require hospitalizations. The symptoms of asthma can range from mild to severe, and the treatment is based on the severity of the disease.
Identification
A patient who is having an asthma attack will generally complain of a cough, shortness of breath and wheezing, which is a high-pitched whistling sound heard with breathing. When a patient is having an asthma attack, his routine medications may not be enough to prevent the attack from worsening, and he might need additional medical treatment.
Prevention
A variety of stimulants can cause an asthma attack. The 2007 National Asthma Education and Prevention Program emphasizes the importance of controlling the environment and triggers that exacerbate asthma. For patients with asthma, knowing what the triggers are and avoiding them can improve the management of their attacks. Common triggers can be animal dander, molds, pollen or cigarette smoke. For some patients, exercise will bring on an attack, and certain foods can be a trigger, also.
Short-acting Medications
A patient with asthma can often prevent or manage an attack with the use of short-acting medications used three to four times a day; these are given by an inhaler or a nebulized mist. These medications are called bronchodilators, and they dilate and relax the airway muscles of the lungs. By opening the airways, there is decreased resistance and the airflow improves. Examples of bronchodilators may include Proventil, Primatene Mist and Xopenex.
Considerations
Managing asthma may require a combination of medications. Steroids are often used in combination with the short-acting medications to help prevent asthma attacks by reducing inflammation and the amount of mucous produced. They can be administered by an inhaler, a nebulizer or intravenously. Someone with asthma may need to take steroids daily for best results, and the symptoms improve once a stable level in the body is reached. Examples of these medications may be Decadron, Azamacort or Prednisone. A health care provider may prescribe other anti-inflammatory drugs called leukotriene modifiers to patients with asthma. Leukotrienes are chemicals made by the body that cause constriction of the airways. These medications are used to stop the buildup of leukotrines. Singulair and Accolate are two leukotriene modifiers.
Severe Attacks
In severe asthma attacks, the patient may need to be admitted to the hospital. Depending on the severity of the attack, the patient may require that a breathing tube be placed through the mouth into the trachea, which will then be connected to a mechanical breathing machine. The machine will breathe for the patient. A combination of medications will be administered until the asthma attack has subsided and the patient's oxygen level is stable enough for her to be removed from the breathing machine.
References
- "Sheehy's Emergency Nursing Principles and Practice"; Mosby Elsevier; 2010
- National Heart Lung and Blood Institute: Guidelines for Diagnosis and Management of Asthma
