Asthma is a chronic airway disease characterized by inflammation, hyperreactivity, and airway obstruction. Also, it has become a major public health concern all over the world. An asthma attack, also referred to as an exacerbation, can occur suddenly, and in turn requires urgent and effective nursing interventions to alleviate its symptoms, stabilize the patient, and prevent any complications that may arise.
The key nursing interventions for asthma attack are highlighted in this article and form a summary for all healthcare professionals who will be involved in managing it.
Understanding Asthma and Its Triggers
Asthma is a very common chronic condition affecting millions of people of all ages around the world; it usually starts in childhood. It may be precipitated by many elements such as allergens for example, pollen, dust mites, and animal dander-environmental pollutants, respiratory infections, exercise, and weather changes.
Nurses, being significant in the assessment of the patient and establishment of a management plan, must therefore have this knowledge about asthma triggers. The inflammation and swelling of the bronchial tubes lead to increased mucus production and bronchoconstriction during an asthma attack.
Symptoms generally manifest as wheezing, shortness of breath, chest tightness, or coughing. Since asthma attacks can be fatal, nursing management should promptly and appropriately intervene.
Initial Assessment
Assessment of the patient’s condition is the foremost step in asthma attack management, which must be comprehensive and include:
- History
A detailed history is to be taken regarding the triggers of asthma, previous exacerbation, adherence to medications, and past history of hospital admissions. This sets a background for the nurse on which a suitable care plan can be developed.
- Physical Examination
Respiratory assessment: Respiratory rate of the patient, accessory muscles used, and the nature of breath sounds, wheezing, or silent chest.
Pulse oximetry: This measures the level of oxygen saturation to ascertain the severity of the attack.
Peak expiratory flow rate (PEFR): If this is available, one could have an idea about the level of airway obstruction.
- Assessing the Severity
Therefore, by following established guidelines, such as those based on the NANDA criteria, the nurse can determine the intensity of the asthma attack to be mild, moderate, or severe. This presents a basis for the intensity of the nursing interventions for asthma attack required.
Nursing Interventions for Asthma Attack
The nurse may institute appropriate interventions based on the initial assessment to address the asthma attack. The different nursing interventions follow, broadly categorized into immediate steps for action and supportive care. Furthermore, the immediate action steps include:
- Administer Bronchodilator Therapy
Bronchodilators continue to be the cornerstone of treatment in acute asthma. Short-acting beta-2 agonists, like albuterol, are given promptly based on the severity of the attack and must be provided using MDI or nebulizer. Nurses should instruct all patients about the proper use of inhalers and holding their breath for a few seconds after inhalation to allow for optimal absorption of the medication.
- Oxygen Therapy
If the oxygen saturation is less than 90%, immediate administration of supplemental oxygen is necessary to maintain adequate oxygenation. The nurse should closely monitor the response to therapy, which will manifest as pulse oximetry, and adjust the flow rate accordingly.
- Corticosteroids
In moderate and severe attacks, systemic corticosteroids such as prednisolone may be indicated to reduce inflammation of the airways. The nurse should facilitate the timely administration of these medications in keeping with established protocols.
Care Measures
The care measures related to the nursing interventions for asthma attack must include:
- Positioning
The patient should be encouraged to sit upright. This will encourage better lung expansion and allow the patient an opportunity to breathe with ease. Therefore, this position relieves pressure on the diaphragm and encourages airflow into the lungs.
- Emotional Support
Asthma attacks can cause a lot of anxiety and distress for the patient. Reassurance, keeping the environment calm, and talking to the patient will help decrease some anxiety. Moreover, the nurse should reassure the patient with proper communication and make them feel that they are being closely monitored.
- Monitoring Vital Signs
Furthermore, the continuous observation of the patient’s vital signs, including heart rate, respiratory rate, and blood pressure, is to be carried out. All these should be documented if they are outside normal ranges, and the health professional should be informed immediately.
- Asthma Management Education
Once the acute crisis has been managed, nurses can provide a great service in patient education. There is no doubt that education regarding early signs of an asthma attack, avoidance of known triggers, and proper medication use (and the importance of controller medications) can be extremely empowering for patients with asthma.
Prevention and Long-Term Management
Apart from the management of acute asthma attacks, nurses should also concern themselves with long-term management and prevention. These nursing interventions for asthma attack may involve:
- Formulation of Asthma Action Plan
The nurse should be able to work together with the patient in formulating his personal asthma action plan. The action plan should include daily management strategies, recognizing his symptoms, and what to do in the event of a flare-up.
- Follow-Up
Another significant thing is to establish follow-up visits to the healthcare provider for ongoing asthma management. Assessment may be routinely made regarding changes in control, with medication adjustments as necessary.
- Enhancing Asthma Education Program Participation
A patient and his family will gain adequate knowledge on how to manage asthma when they participate in an asthma education program. Proper inhaler techniques, identification of triggers, and other lifestyle changes can be learned through such programs.
The Bottom Lines
The management of the asthma attack is a very complex process that involves timely nursing interventions, detailed assessment, and continuous education for the patient. The nursing intervention for asthma attack plays an important role in improving the patient’s outcome in acute exacerbation by using a systematic approach, as well as incorporating compassionate treatment in the long-term management of asthma.
Nurses, through education and preventive strategies, enable the individual with asthma to feel a sense of control about their disease and minimize the impact of a chronic illness on daily functioning. It is possible that the role of the nurse goes beyond crisis intervention to creating a future of living with asthma through teaching, advocacy, and support.
FAQs
- What are the 4 ways to manage asthma?
- Beware of asthma symptoms such as wheeze, cough, breathing difficulty, etc.
- Avoid triggers as much as possible
- Know correct use of inhalers
- Use a spacer
- What are the 5 main goals of asthma management?
- No symptoms of asthma during night & day
- No limitation of activities
- No missed work or school
- No hospital or emergency room visit
- Reduced the requirement of quick relief medicine
- What breathing exercise is good for asthma?
- Buteyko breathing
- Papworth method
- Diaphragmatic breathing
