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    Status Asthmaticus

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    Daianne Joy Donato
    Status asthmaticus is a severe form of asthma attack lasting more than 24 hours. It requires immediate medical treatment including bronchodilators, corticosteroids, oxygen, and IV fluids. Patients may require intubation and mechanical ventilation. Nursing priorities are to maintain airway patency, assist with breathing treatments, provide hydration and nutrition, monitor for complications, and educate the patient. Treatment goals are to restore airway function and gas exchange through aggressive medical and nursing interventions.

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    Status Asthmaticus

    Uploaded by

    Daianne Joy Donato
    455 views15 pages
    Status asthmaticus is a severe form of asthma attack lasting more than 24 hours. It requires immediate medical treatment including bronchodilators, corticosteroids, oxygen, and IV fluids. Patients may require intubation and mechanical ventilation. Nursing priorities are to maintain airway patency, assist with breathing treatments, provide hydration and nutrition, monitor for complications, and educate the patient. Treatment goals are to restore airway function and gas exchange through aggressive medical and nursing interventions.

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    Status Asthmaticus

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    Status asthmaticus is a severe form of asthma attack lasting more than 24 hours. It requires immediate medical treatment including bronchodilators, corticosteroids, oxygen, and IV fluids. Patients may require intubation and mechanical ventilation. Nursing priorities are to maintain airway patency, assist with breathing treatments, provide hydration and nutrition, monitor for complications, and educate the patient. Treatment goals are to restore airway function and gas exchange through aggressive medical and nursing interventions.

    Copyright:

    © All Rights Reserved
    455 views15 pages

    Status Asthmaticus

    Uploaded by

    Daianne Joy Donato
    Status asthmaticus is a severe form of asthma attack lasting more than 24 hours. It requires immediate medical treatment including bronchodilators, corticosteroids, oxygen, and IV fluids. Patients may require intubation and mechanical ventilation. Nursing priorities are to maintain airway patency, assist with breathing treatments, provide hydration and nutrition, monitor for complications, and educate the patient. Treatment goals are to restore airway function and gas exchange through aggressive medical and nursing interventions.

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    © All Rights Reserved
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    At a glance
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    Status asthmaticus is a severe form of asthma that does not respond to conventional therapy and can last more than 24 hours. It requires hospital treatment with medications and oxygen.

    Short, shallow breaths, wheezing, coughing, difficulty breathing, heavy sweating, trouble speaking, fatigue and weakness, abdominal/back/neck pain, panic/confusion, blue lips/skin, loss of consciousness.

    Ineffective airway clearance, fear, impaired gas exchange, imbalanced nutrition, deficient knowledge.

    STATUS

    ASTHMATICUS
    Description
    “Status asthmaticus” is a medical term for
    the most severe form of an asthma attack. If
    it happens, you may have to go to the
    hospital to get it treated.

    Is severe, persistent asthma that does not


    respond to conventional therapy.

    The attacks last longer than 24 hours


    Etiology
    Respiratory infections
    Severe stress
    Cold weather
    Severe allergic reactions
    Exposure ti chemicals and other irritants
    Smoking
    Pathophysiology
    Pathologic changes in the airway

    Airflow obstruction

    Premature airway closure on expiration

    Dynamic hyperinflation

    Hypercarbia
    Pathophysiology
    Dynamic hyperinflation or “air-
    trapping” also leads to ventilation /
    perfusion (V/Q) mismatching
    Signs & Symptoms
    • difficulty breathing
    • short, shallow breaths • heavy sweating
    • wheezing • trouble speaking
    • fatigue and weakness
    • coughing • abdominal, back, or neck muscle pain
    • panic or confusion
    • blue-tinted lips or skin
    • loss of consciousness
    Nursing Diagnosis
    •Ineffective Airway Clearance related to bronchospasms and increased
    pulmonary secretions.
    •Fear related to breathlessness and recurrences
    •Impaired Gas Exchange
    •Imbalanced Nutrition: Less Than Body Requirements
    •Deficient Knowledge
    Planning & Implementation
    Nursing Priorities
    1.Maintain/establish airway patency
    2.Assist with measures to facilitate gas exchange.
    3.Enhance nutritional intake
    4.Prevent complications and slow progression of condition.
    5.Provide information about disease process, prognosis, and treatment regimen.
    Medical Management
    •Initial treatment: beta-2-adrenergic agonists, corticosteroids, supplemental oxygen and IV
    fluids to hydrate patient. Sedatives are contraindicated.
    •Highflow supplemental oxygen is best delivered using a partial or complete nonrebreather
    mask (PaO2 at a minimum of 92 mm Hg or O2 saturation greater than 95%).
    •Magnesium sulfate, a calcium antagonist, may be administered to induce smooth
    muscle relaxation.
    Medical Management

    •Hospitalization if no response to repeated treatments or if blood gas levels deteriorate or


    pulmonary function scores are low.
    •Mechanical ventilation if patient is tiring or in respiratory failure or if condition does not
    respond to treatment.
    Nursing Management

    •Constantly monitor the patient for the first 12 to 24


    hours, or until status asthmaticus is under control. Blood
    pressure and cardiac rhythm should be monitored
    continuously during the acute phase and until the patient
    stabilizes and responds to therapy.
    •Assess the patient’s skin turgor for signs of dehydration;
    fluid intake is essential to combat dehydration, to loosen
    secretions, and to facilitate expectoration.
    Nursing Management

    •Administer IV fluids as prescribed, up to 3 to 4 L/day,


    unless contraindicated.
    •Encourage the patient to conserve energy.
    •Ensure patient’s room is quiet and free of respiratory
    irritants (eg, flowers, tobacco smoke, perfumes, or odors
    of cleaning agents); nonallergenic pillows should be used.
    Evaluation
    •Maintenance of airway patency.
    •Expectoration or clearance of secretions.
    •Absence /reduction of congestion with breath sound clear, noiseless respirations, and
    improved oxygen exchange.
    •Verbalized understanding of causes and therapeutic management regimen.
    •Demonstrated behaviors to improve or maintain clear airway.
    •Identified potential complications and how to initiate appropriate preventive or
    corrective actions.
    Home Health Considerations
    1.Take your asthma medication as often as your doctor recommends.
    2.Use a peak flow meter several times a day. These devices help to check on how well
    your lungs are working. Start treatment immediately according to your asthma action
    plan, if you notice a lower reading, even if you feel fine.
    3.Keep up with your doctor appointments to find out how well your lungs are doing and
    to make sure your medicines are working well for you.

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