NURSING CARE PLAN- Bronchial Asthma ASSESSMENT

Subjective:

“I have a hard time breathing, said the patient.”

Objective:

(1) Use of accessory muscle.

(2) Abnormal breath sounds.

(3) V/S taken as follows:

T: 37.3P: 82R: 25

BP: 110/80

DIAGNOSIS

Ineffective airway clearance related to increased productionof secretions.

INFERENCE

Bronchial asthma is a chronic inflammatory disease of the airways, associated with recurrent, reversible airway obstruction with intermittent episodes of wheezing and dyspnea. Bronchial hypersensitivity is

caused by various stimuli, which innervate the vagus nerve and beta adrenergic receptor cells of the airways, leading to bronchial smooth muscle constriction, hypersecretion of mucus, and mucosal edema.

PLANNING

After 3 days of

nursing interventions, the patient will demonstrate behaviors to improve airway clearance.

INTERVENTION

Independent:Auscultate breath sounds. Note breath sounds like wheezes, crackles and rhonci.

Elevate head of the bed, have patient lean on overhead table or sit on the edge of the bed.

Keep environmental pollution a minimum. EX: dust,

smoke, and feather pillows.

Encourage or assist with abdominal or pursed lip breathing exercises.

RATIONALE

Some degree of bronchoplasm is present with obstructions in airway and may or may not be manifested in adventitious breath sounds.

Elevation of the bed

NURSING CARE PLAN- Bronchial Asthma facilitates respiratory function by use of gravity.

Precipitators of allergic type of respiratory reactions that can trigger or exacerbate onset of acute episode.

Provides patient with some means to cope with or contol dyspnea and reduce air tapping.

EVALUATION

After 3 days of nursing

intervention, the patient was able to demonstrate behaviors to improve airway clearance.

Assist with measures to improve effectiveness of cough effort.

Incresed fluid intake to 3000 ml/day. Provide warm or tepid liquids.

Collaborative:Administer bronchodilators as prescribed.

Coughing is most

NURSING CARE PLAN- Bronchial Asthma effective in an upright position after chest percussion.

Hydration helps decrease viscosity of secretions, facilitating expectoration. Using warm liquids may decrease bronchospasm.

To reduce the viscosity of secretions.