Nursing Care Plans
This post contains 5 bronchial asthma nursing care plans.
Ineffective Airway Clearance
The presence of a foreign microorganism triggers the B lymphocyte to produce antibodies that are specific to that antigen. These antibodies then attach to mast cells in the lungs. The mast cells with the antibody attaches to the antigen and begins to degranulate. This degranulation causes the release of certain chemical mediators, namely, histamine, bradykinin, prostaglandin, and leukotriene. These chemical mediators cause bronchospasm leading to bronchoconstriction, increased vascular permeability leading to fluid leakage from the lung vasculature and increased mucus production. These lead to swelling of the bronchi, mucus buildup that plugs the airway and decreased bronchial diameter. This causes an increased airway resistance and a constricted pathway for air. Air cannot pass effectively and this manifests as a whistling sound. Coughing is a way to expel the obstruction (mucus plug) while dyspnea is a manifestation of the increased airway resistance.
NDx: Ineffective airway clearance RT bronchoconstriction, increased mucus production, and respiratory infection AEB wheezing, dyspnea, and cough
Ineffective Breathing Pattern
Presence of secretions in the bronchi will result into a blockage of air that will enter the body and thus producing insufficient air needed by the body. And inability to maintain clear airway. This obstruction is further heightened by bronchospasm due to the contraction of the smooth muscles in the bronchi. This is caused by parasympathetic stimulation of the muscarinic m2 receptors as well as by chemical mediators released in response to the presence of allergen
Impaired Gas Exchange
Bronchial asthma is a condition wherein the airway diameter is highly reduced. This is due to severe bronchospasm, mucosal edema and mucus plug formation. There is a rise in airway resistance which leads to decreased amount of air that enters upon inspiration as well as expiration. Thus, ventilation is impaired. In bronchial asthma, perfusion is not directly affected. However, the balance between ventilation and perfusion (V/Q ratio) is lost because despite the adequate perfusion (capillary circulation), not much gas is available to diffuse from the alveoli to the capillaries. Conversely, the gases in the capillaries do diffuse to the alveoli but since expiration is impaired, such gases fail to be ventilated out. Thus, gas exchange is impaired
Fluid accumulation in the lungs makes it difficult to breathe. The fluid inside prohibits the lungs to expand thus it is harder to breathe. The client, to have adequate ventilation makes use of his accessory muscles to breathe to have sufficient air. With too much use of the accessory muscles, feeling of tiredness may be present resulting to fatigue which is experienced by the client
Risk for Activity Intolerance
Inadequate oxygen in the circulation can develop weakness in our muscles. Muscles need oxygen to move and to do its function. If the patient cannot tolerate any activities because of the low oxygenation caused by the ventilation-perfusion imbalance caused by the pathological minimized lung expansion.