Drug therapy Three types of anti-inflammatory drugs Corticosteroids (e.g., beclomethasone, budesonide) Suppress inflammatory response Reduce bronchial hyper-responsiveness Decrease mucous production Inhaled form is used in

Interprofessional care The current guidelines focus on Assessing the severity of the disease at diagnosis and initial treatment and then Monitoring periodically to control the

Diagnostic studies Detailed history and physical exam Spirometry Peak expiratory flow rate (PEFR) Chest x-ray Oximetry Allergy testing Blood levels of eosinophils Diagnostic Assessment History

Clinical manifestation Recurrent episodes of wheezing, breathlessness, cough, and tight chest Expiration may be prolonged. Inspiration-expiration ratio of 1:2 to 1:3 or 1:4 Bronchospasm, edema,

Pathophysiology Primary response is chronic inflammation from exposure to allergens or irritants Leading to airway bronchoconstriction, hyper-responsiveness, and edema of airways Exposure to allergens or

Asthma Heterogeneous disease characterized by a combination of clinical manifestations along with reversible expiratory airflow limitation or bronchial hyper-responsiveness Affects about 18.8 million Americans Women

Nursing implementation Health Promotion Ultimate goal in the United States is eradication Selective screening programs in high-risk groups to detect TB Treatment of LTBI Follow-up

Nursing Assessment History Physical symptoms Productive cough Night sweats Afternoon temperature elevation Weight loss Pleuritic chest pain Crackles over apices of lungs Sputum collection Nursing

Nursing Assessment History Physical symptoms Productive cough Night sweats Afternoon temperature elevation Weight loss Pleuritic chest pain Crackles over apices of lungs Sputum collection Nursing

Interprofessional care Hospitalization not necessary for most patients Infectious for first 2 weeks after starting treatment if sputum + Drug therapy used to prevent or

Diagnostic Studies Tuberculin skin test (TST) AKA: Mantoux test Uses purified protein derivative (PPD) injected intradermally Assess for induration in 48 – 72 hours Presence

Complications Miliary TB Large numbers of organisms spread via the bloodstream to distant organs Fatal if untreated Manifestations progress slowly and vary depending on which