CHAPTER 2 Respiratory System^93
NURSING INTERVENTION
- Administer chest percussion and vibration to loosen and expel secretions.
- Explain to patient:
- How to avoid infections (reduced exposure to others with an infection and
vaccines administered according to physician’s orders). - Proper use of oxygen therapy.
- How to avoid infections (reduced exposure to others with an infection and
Asthma
WHAT WENT WRONG?
The airways become obstructed from either inflammation of the lining of the air-
ways or constriction of the bronchial smooth muscles (bronchospasm). A known
allergen, for example, pollen—is inhaled, causing activation of antibodies that rec-
ognize the allergen. Mast cells and histamine are activated, initiating a local inflam-
matory response. Prostaglandins enhance the effect of histamine. Leukotrienes also
respond, enhancing the inflammatory response. White blood cells responding to the
area release inflammatory mediators.
A stimulus causes an inflammatory reaction, increasing the size of the bronchial
linings; this results in restriction of the airways. There may be a bronchial smooth
muscle reaction at the same time. There are two kinds of asthma:
- Extrinsic asthma, also known as atopic, caused by allergens such as pollen,
animal dander, mold, or dust. Often accompanied by allergic rhinitis and
eczema; this may run in families. - Intrinsic asthma, also known as nonatopic, caused by a nonallergic factor
such as following a respiratory tract infection, exposure to cold air, changes
in air humidity, or respiratory irritants.
PROGNOSIS
Triggers for the asthmatic patient can often be identified and avoided. Patients can
learn to check peak flow levels and manage symptoms in conjunction with their
caregiver. Well controlled asthma typically has temporary, reversible exacerba-
tions that can be controlled with medications, often in an outpatient setting. With
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