Asthma is a chronic respiratory condition that affects the airways, causing them to become inflamed and narrowed. This narrowing can make it difficult for patients to breathe, leading to wheezing, coughing, shortness of breath, and chest tightness—which are the clinical manifestations of asthma.
According to the WHO, asthma affected an estimated 262 million people in 2019 and caused 455,000 deaths. In the Philippines, 12% of the population, or approximately 10.8 million people, have asthma. This indicates that a significant majority of Filipino asthma patients—approximately 98%—lack proper treatment.
Causes and Risk Factors
The exact cause of asthma is unknown, but it is believed to be a combination of genetic and environmental factors. Some risk factors for developing asthma include:
- Allergies: Individuals with allergies, such as to pollen, dust mites, or pets, are more likely to develop asthma.
- Family history: If a parent or sibling has asthma, their children are more likely to develop it.
- Exposure to irritants: Exposure to irritants like cigarette smoke, air pollution, or strong chemicals can trigger asthma symptoms.
- Infections: Early childhood infections, such as respiratory syncytial virus (RSV), may increase the risk of developing asthma.
Diagnostic Procedures
To diagnose asthma, a healthcare provider typically conducts a physical exam and reviews the patient’s medical history. They may also order the following tests:
- Pulmonary function tests: These tests measure how well the lungs are functioning.
Types of Pulmonary Function Tests:
- Spirometry: This is the most common lung function test. It measures how much air the patient can breathe in and out, and how fast they can blow the air out.
- Peak flow: This test measures how fast the patient can blow air out of the lungs. It can help detect the narrowing of the airways and monitor asthma control.
- Allergy testing: Allergy testing can help identify allergens that may be triggering asthma symptoms.
Types of Allergy Tests:
- Skin tests: Small amounts of suspected allergens are placed on or under the skin. If the patient is allergic, they will develop a small raised bump.
- Blood tests: These tests measure the levels of allergy-related antibodies in the blood.
Asthma Pathophysiology
To understand the pathophysiology of asthma, consider the airways as similar to a straw. When a person breathes, air travels through this straw to their lungs. In people with asthma, the straw can become narrowed or blocked when triggered by allergens or other factors. This makes it harder for the patient to breathe.
In asthma, the airways become swollen and irritated. The muscles around the airways tighten, making the pathway narrower. More mucus is also produced, clogging the airways like a sticky substance in the straw. When this happens, it’s like trying to breathe through a narrow straw, causing wheezing, coughing, and shortness of breath.
Triggers like dust, pollen, or cold air can cause these problems to flare up, so patients with asthma should avoid these triggers.
Treatment
Asthma can be effectively managed with proper treatment. The goal is to control symptoms and prevent asthma attacks. Common treatment options include:
- Inhaled medications: These are medicines the patient breathes in, often using a device like a nebulizer or an inhaler. They help open up airways, making it easier to breathe and reducing swelling in the airways.
- Oral medications: These are pills or liquids taken by mouth. If asthma doesn’t improve with inhalers, doctors might prescribe oral medications. They work to calm the inflammation in the airways over time, helping to prevent asthma attacks.
- Avoiding Triggers: It’s important to identify and avoid triggers that worsen asthma. Common triggers include smoke, dust, pet dander, mold, or strong smells. For example, keeping the home clean and avoiding smoke can make a big difference for the patient.
Nursing Interventions
Nurses play a crucial role in managing asthma. They may:
- Educate patients: Provide education about asthma, its triggers, and treatment options.
- Monitor symptoms: Monitor patients’ symptoms and adjust their treatment plans as needed.
- Teach breathing techniques: Teach patients breathing techniques to help manage symptoms during an asthma attack.
- Administer medications: Administer medications as prescribed, such as inhaled corticosteroids or bronchodilators.
Health Teaching
Nurses provide essential health teachings to help prevent asthma attacks and manage the condition effectively. Here are some important health teachings for patients with asthma:
- Educate patients about asthma and its pathophysiology. Explain common asthma triggers, such as allergens (pollen, dust mites, pet dander), irritants (smoke, strong odors), respiratory infections, and exercise.
- Teach proper inhaler and nebulizer use, including the importance of timing and technique to ensure effective medication delivery.
- Emphasize the importance of medication adherence, instructing patients to take prescribed medications regularly, even when symptoms are not present, to maintain control over asthma.
- Provide strategies to reduce exposure to known triggers, such as using air purifiers, maintaining a clean home environment, and avoiding smoking.
- Educate on controlling allergens at home, including using hypoallergenic bedding and regular cleaning to reduce dust and mold.
- Assist in creating a personalized asthma action plan that outlines daily management strategies, medication use, and steps to take during an asthma attack.
- Teach relaxation techniques to manage stress, which can be a trigger for asthma symptoms.
By focusing on these areas, nurses can empower patients to take active steps in managing their asthma and preventing exacerbations, ultimately improving their quality of life.
Asthma Pathophysiology and Schematic Diagram
References
- Health corner. Retrieved August 29, 2024, from Gov.ph website: https://rmc.doh.gov.ph/patientscorner/health-corner
- Asthma. Retrieved August 29, 2024, from Who.int website: https://www.who.int/news-room/fact-sheets/detail/asthma
- Hinkle, J. L., & Cheever, K. H. (2014). Brunner & Suddarth’s textbook of medical-surgical nursing (Edition 13.). Wolters Kluwer Health/Lippincott Williams & Wilkins.
