Asthma

Pediatric NCLEX Review Respiratory Disorders Learning Activities/Questions Asthma

What is it?

Asthma is a chronic inflammatory condition of the lungs characterized by episodes of wheezing, breathlessness, chest tightness, and coughing. These episodes can be triggered by a variety of factors such as exercise, allergens (such as dust or pollen), pollution, and respiratory infections.

Symptoms

Difficulty breathing or shortness of breath
Chest tightness or pain
Wheezing (a whistling sound when breathing).
Coughing (especially at night or early morning)
Rapid breathing.
During an asthma attack, the airways become narrowed due to inflammation and the muscles surrounding the airways tighten, making it harder to breathe.
Diminished breath sounds = airways nearly closed.

Treatment

Priority is to avoid triggers
Inhaled corticosteroids
Leukotriene modifiers
Long-acting beta-agonists
Immunomodulators
Quick-relief medications, also known as rescue medications: short-acting beta-agonists and anticholinergics.

Medications

Short-acting beta agonist: Albuterol. Used as a rescue inhaler during as asthma attack
Leukotriene modifiers: Montelukast (Singulair). Works by blocking the action of leukotrienes, which are chemicals in the body that cause inflammation and swelling in the airways.
Long-acting beta agonist: Salmeterol. Taken daily to prevent attacks
Inhaled corticosteroids work by reducing inflammation in the airways, which helps to prevent asthma attacks. Examples: fluticasone, budesonide and beclomethasone. Note that they end in -sone or -sonide.
Immunomodulators: benralizumab, mepolizumab, reslizumab. Notice the ending of these medications. These medications are used for severe asthma.

Severity of Asthma

1. Mild intermittent asthma: Symptoms occur less than twice a week and only last for a few hours or days. Nighttime symptoms < 2x/month
2. Mild persistent asthma: Symptoms occur at least twice a week, but not every day, and may affect daily activities. Nighttime symptoms > 2x/month
3. Moderate persistent asthma: Symptoms occur daily and may affect daily activities, including exercise. Nighttime symptoms > weekly.
4. Severe persistent asthma: Symptoms occur frequently and may be disabling, affecting daily activities and quality of life. Frequent nighttime symptoms. Treatment may require the use of high-dose medication and/or oral corticosteroids.