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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...

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 fatal risk factors
nr 566 week 2 chapter 30 asthma and copd
diagnosis classification of asthma
risk factors for fatal asthma attacks
asthma step therapy and goals of therapy
treatment maintenance

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N R 566 Week 2 CHAPTER 30: Asthma and COPD

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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