Nursing Diagnosis for Asthma: 8 Nursing Care Plans

Nursing Interventions	Rationale
Nursing Assessment
Assess respiratory rate, depth, and rhythm.	Changes in the respiratory rate and rhythm may indicate an early sign of impending respiratory distress.
Assess for color changes in the buccal mucosa, lips, and nail beds.	Cyanosis indicates low oxygenation and that breathing is ineffective to maintain adequate tissue oxygenation.
Auscultate lungs for adventitious breath sounds (wheezes and rhonchi).	Wheezes suggest partial obstruction or resistance. While rhonchi may indicate retained secretions in the lungs.
Assess the effectiveness of cough.	Coughing is a natural way to clear the throat and breathing passage of foreign particles, irritants, and mucus. Severe bronchospasm, thick secretions, and respiratory muscle fatigue are some of the causes of an ineffective cough.
Assess the amount, color, odor and viscosity of the secretions.	Normal secretion is clear or gray and minimal; abnormal sputum is green, yellow, or bloody; malodorous; often copious. Thick tenacious secretions increase airway resistance.
Monitor and record intake and output (I&O) adequately.	Provides information on the fluid balance of the patient. Dehydration can contribute in viscous secretions and may result to decrease airway clearance.
Monitor oxygen saturation using pulse oximetry.	Oxygen saturation of less than 90% indicates problems with oxygenation.
Monitor chest x-ray results.	A chest x-ray provides information regarding the presence of infiltrates, lung inflation, or the presence of barotrauma.
*Monitor laboratory results as indicated:*
White blood cell count	Increased WBC count indicates an infection.
Potassium	The use of beta-adrenergic agonists shift potassium into the cell and cause hypokalemia.
Theophylline level (if on theophylline therapy)	Therapeutic range of theophylline is between 10 to 20 mcg/mL. Signs of toxicity include hypotension, tachycardia, GI symptoms, and restlessness.
Monitor arterial blood gasses (ABGs).	Retention of carbon dioxide happens due to fatigue from labored breathing caused by bronchospasm. Once the client is mechanically ventilated, permissive hypercapnia may be utilized to prevent lung damage and maintain plateau pressure less than 30 to 35 cm H₂0.
Obtain peak expiratory flow rate (PEFR) or forced expiratory volume in 1 second (FEV₁) before and after respiratory treatment.	Peak expiratory flow rate (PEFR) is the maximum flow rate generated during forceful exhalation. It should be improved with effective therapy. FEV₁ is the volume exhaled during the first second of a forced expiratory maneuver started from the level of total lung capacity.
Therapeutic Interventions
Pace the client’s activities.	Break up activities into smaller parts and take rest breaks in between to avoid fatigue. increased effort in breathing properly.
Encourage deep breathing and coughing exercises.	Helps loosen and expectorate excess secretions and contribute in effective clearing mucus out of the lungs.
Encourage increased fluid intake of up to 3000 ml/day within cardiac or renal reserve.	Fluids help minimize mucosal drying and increases ciliary action to remove secretions.
Limit alcohol and caffeinated drinks.	When consumed in excess, it may contribute to dehydration making difficulty for secretions to be expectorated. In addition, it may also increased the risk of CNS and cardiovascular system side effects of medications.
Administer IV fluids and medication as ordered.	IV fluid therapy can be beneficial for clients with dehydration. Medications such as bronchodilators and inhaled corticosteroids may be prescribed.
Administer oxygen as ordered.	Oxygen therapy corrects hypoxemia, which can be caused by retained respiratory secretions.
Anticipate the need for intubation and mechanical ventilation.	Acute exacerbations of asthma can lead to respiratory failure requiring mechanical ventilation.

8 Asthma Nursing Care Plans

What is asthma?

Nursing Care Plans

2. Ineffective Airway Clearance

Ineffective Airway Clearance

2. Ineffective Airway Clearance

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