- Nursing diagnoses
- Ineffective airway clearance related to bronchospasm, excessive mucus production, tenacious secretions, and fatigue
- Anxiety related to difficulty breathing, perceived or actual loss of control, and fear of suffocation
- Deficient knowledge related to lack of information and education about asthma and its treatment
- Planning
- Minimal symptoms during the day and night
- Acceptable activity levels (including exercise and other physical activity)
- Maintenance of greater than 80% of personal best PEFR
- Few or no adverse effects of therapy
- No acute exacerbations of asthma
- Adequate knowledge to participate in and carry out the plan of care.
- Nursing implementation
- Important patient teaching
- Seek medical attention for bronchospasm or when severe side effects occur
- Maintain good nutrition
- Exercise within limits of tolerance
- Uninterrupted sleep is important
- Written asthma action plan
- Measure peak flow at least daily
- Patients with asthma frequently do not perceive changes in their breathing
- Peak flow results
- Green Zone
- Usually 80% to 100% of personal best
- Remain on medications
- Yellow Zone
- Usually 50% to 80% of personal best
- Indicates caution
- Something is triggering asthma.
- Red Zone
- 50% or less of personal best
- Indicates serious problem
- Definitive action must be taken with health care provider
- Evaluation
- Maintain clear airway with removal of excessive secretions
- Have normal (for the individual) breath sounds and respiratory rate
- Report decreased anxiety with increased control of respirations
- Describe the disease process and treatment regimen
- Demonstrate correct administration of inhaled drugs
- Express confidence in ability for long-term management of asthma
- Green Zone
- Important patient teaching
Cultural considerations: Asthma
- African Americans and Hispanics have higher rates of poorly controlled asthma and deaths
- Disparities in socioeconomic status and access to proper health care
- Cultural beliefs about management of asthma
