NR566_ Week 2 CHAPTER 30: Asthma and COPD complete study guide
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Course
AIT Nursing (NR566)
Institution
Thompson River University (TRU
)
Diagnosis Classification of Asthma:
Adults and >12 yo:
o Mild intermittent asthma
s/sx occur less often twice a week
pt is asymptomatic in b/w exacerbation
nighttime symptoms: <2x a month
PEF: >80% predicted
SABA use: < 2x a week
o Mild persistent asth...
Diagnosis Classification of Asthma:
Adults and >12 yo:
o Mild intermittent asthma
s/sx occur less often twice a week
pt is asymptomatic in b/w exacerbation
nighttime symptoms: <2x a month
PEF: >80% predicted
SABA use: < 2x a week
o Mild persistent asthma
s/sx occur more often than twice a week, but less often than once a day
exacerbation may affect activity
nighttime symptoms: 3-4x a month
PEF: >80% predcited
SABA use: >2x a week (but not daily, not >once a day)
o Moderate persistent asthma
s/sx: daily
exacerbation affects normal activity
nighttime symptoms: >once a week
PEF: >60% and <80%
SABA use: daily
o Severe persistent asthma
s/sx: some degree of s/sx ALL THE TIME.
Extremely limited physical activity with frequent exacerbations
Nighttime symptoms: often 7x a week
PEF: decreased, <60% predicted
Children
o Mild intermittent asthma
s/sx occur less often than twice a week
pt is asymptomatic in b/w exacerbation
nighttime symptoms:
0-4 yo: none
5-11 yo: <2x a month
PEF: >80% predicted
SABA use: < 2x a week
Corticosteroids use: no more than once a year
o Mild persistent asthma
s/sx occur more often than twice a week, but less often than once a day
exacerbations may affect activity
, <4 yo: >2x in 6months requiring systemic steroids or 4 episodes of
wheezing in a year lasting more than a day and risk factors for persistent
asthma.
5-11 yo: 2 or more exacerbations a year
nighttime symptoms:
0-4 yo: 1-2x a month
5-11 yo: 2-4x a month
PEF: >80% predicted
SABA use: > 2x a week
o Moderate persistent asthma
s/sx: daily
exacerbations: 2 or more per year
nighttime symptoms:
<4 yo: 3-4x a month
5-11 yo: > 1x a week, but not nightly
SABA use: daily
PEF: >60% and <80%
o Severe persistent asthma
s/sx: some degree of s/sx ALL THE TIME.
Extremely limited physical activity
Exacerbations: 2 or more a year (5-11 yo)
Nighttime symptoms: frequent
<4 yo: > 1x a week
5-11 yo: 7x a week
PEF: <60% predicted
Risk Factors for Fatal Asthma Attacks
HOME MANAGEMENT OF ASTHMA EXACERBATIONS IS AN INTERGRAL PART OF ASTHMA
MANAGEMENT
Patients need to be educated to recognize early symptoms of decreasing lung function and to
adjust their medications accordingly
Fatal Risk Factors:
o Previous severe exacerbations requiring intubation or ICU admission d/t asthma
o 2 or more hospitalizations or >3 ER visits in a year d/t asthma
o Use of >3 canisters of SABA in a month
o Difficulty perceiving airway obstruction or worsening asthma
o Low socioeconomic status or inner-city residence
Asthma Step Therapy and Goals of Therapy
Goals:
o Reduce impairment:
Prevent chronic and troublesome s/sx (e.g. coughing or breathlessness at night,
early morning, or after exertion)
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