Bronchial asthma

Bronchial asthma is a chronic inflammatory disease of airways resulting from hyper reactivity of the airways to Varity of stimuli

1. BRONCHIAL ASTHMA
By
Mr. Ravi Rai Dangi
Assistant Professor
Fellowship in Neonatal Nursing
MSc. Child Health Nursing

2. DEFINITION
Bronchial asthma is a chronic inflammatory disease of
airways resulting from hyper reactivity of the airways to
Varity of stimuli

3. BRONCHIAL ASTHMA
It is characterized by repeated attacks of cough along
with respiratory distress which reverse either
spontaneously or with some medications .

4. CAUSES
Extrinsic Asthma
oPollens
oHouse dust
oFeathers
oAnimal dander

5. CAUSES
Intrinsic Asthma
oGenetic factors
oRespiratory infections
oChanges in temperature

6. PATHOPHYSIOLOGY
Immediate hypersensitivity to an allergen
Produce specific antibody of the immunoglobulin E. (
IgEis a protein molecule produced in the cell wall)
When IgEis released from the plasma cells it is able
to recognize attach and remain fixed in the mast cells

7. PATHOPHYSIOLOGY
Once IgEhas attached to the mast cells the child is
said to be sensitive to the specific antigen initiating
IgEproduction
When the child is exposed to the antigen IgEmolecule
bind with the antigen on the surface of the mast cell

8. PATHOPHYSIOLOGY
The antigen IgEreaction initiates several biochemical
events that results in the release of Histamine
Histamine causes smooth muscle contraction ,
increased vascular permeability ,edema and
increased mucous secretion
Bronchospasm, Edema , increased secretion of
mucous and inflammation.

11. CLINICAL MANIFESTATIONS
Persistent coughing
Wheezing
Dyspnea ,shortness of breath, rapid breathing and
chest tightness

12. MANAGEMENT
For Life threatening Asthma
Immediately start oxygen inhalation
Subcutaneous injection of terbutaline or adrenaline
Inhalation of terbutaline or adrenaline
IV Hydrocortisone 10 mg / kg
Transfer the patient to PICU

13. MANAGEMENT
For moderate and severe Asthma
Inhalation of terbutaline or Salbutamol repeated
every 20 minutes for 1 hour along with oxygen
inhalation and an oral dose of predinisol (1-2 mg / kg )
.
IV Hydrocortisone 10 mg/ kg

14. MANAGEMENT
Mild Asthma
Mobilization

15. MANAGEMENT
Pharmacological management
Bronchodilators
Adrenaline, terbutalineand salbutamol

16. MANAGEMENT
Corticosteroid,
Dexamethasone
Other drugs-These include mast cell stabilizers (
cromolynsodium, nedocronilsodium and theophylline.

17. MANAGEMENT
Inhalation devices
 Metered dose inhaler
 Metered dose inhaler with spacer
 MDI with face mask
 Nebulizer

18. PREVENTING EXACERBATING
FACTORS
Smoking by parents should be avoided.
It is advisable to keep chemical irritants like strong
odors fumes and smoke from kerosene stove from
minimum.
Families should not have pets, particularly cats and
dog.
House dust mite can be controlled by keeping
carpets, curtains and soft toys to minimum and clean
them periodically

19. PREVENTING EXACERBATING
FACTORS
The bedroom of the child should be kept clean and as
free from dust as possible .
Exposure to air pollution strong odors such as wet
paint , disinfectants and smoke should be minimized.

20. NURSING MANAGEMENT
Ineffective airway clearance related to allergenic
response and inflammation in the bronchial tree.
Activity intolerance related to imbalance between
oxygen supply and demand
Altered family process related to having child with a
chronic illness