Asthma Basics
What type of airway problem occurs in asthma—obstructive or restrictive?
Obstructive
The two key pathophysiologic processes in asthma are Inflammation + Bronchoconstriction.
Why do COPD patients often have a barrel chest?
Air trapping and hyperinflation.
What other assessment (diagnostic findings) might the nurse see?
Hypoxia, Hypercapnia, Dyspnea, Tachypnea, Xray?, Labs?
What lung sound is most commonly heard with asthma?
Wheezing
What is albuterol classified as?
Short-acting beta-2 agonist (SABA).
A COPD patient is given 6 L of oxygen and becomes somnolent. What should the nurse do first?
Reduce O₂ to 1–2 L/min and reassess.
The nurse should teach asthma patients to use caution with herbal supplements because some of these products can cause this harmful effect on the airways.
Bronchoconstriction or worsening asthma symptoms
Certain herbal products (such as echinacea, ephedra/ma huang, ginkgo, and St. John’s wort) can interact with asthma medications or trigger bronchospasm. Essential oils also (irritate airways, provoke coughing). Herbal products are not regulated for purity → inconsistent dosing. Patients often don’t report herbal use unless specifically asked. Reinforce: always consult the provider before starting any herbal supplement.
Why is it important for the nurse to monitor a COPD patient for balanced nutrition?
Because COPD increases the work of breathing, causing higher energy needs and risk for weight loss.
COPD patients burn more calories just trying to breathe. Poor intake + higher energy demands → unintended weight loss. Malnutrition weakens respiratory muscles and worsens breathing. Monitoring nutrition is essential to maintain strength and prevent complications.
Which COPD subtype typically has chronic productive cough for at least 3 months in 2 consecutive years?
Chronic bronchitis.
What is the purpose of inhaled corticosteroids in asthma?
Reduce inflammation.
An asthma patient has wheezing and uses albuterol with no improvement. What’s the next intervention?
Administer systemic corticosteroids.
A child says their asthma is “acting up at school.” Name one common school-related trigger.
Exercise, allergens, cold air, viral illness, or environmental irritants.
What are other triggers?
This position helps a COPD patient breathe more easily by promoting lung expansion and using accessory muscles effectively.
The tripod position
Tripod = leaning forward, elbows on knees or on a table.
This helps open the chest, drop the diaphragm, and engage accessory muscles. A classic sign of respiratory distress in COPD; helps reduce work of breathing. Reinforce that lying flat worsens dyspnea because it limits lung expansion.
What assessment finding indicates impending respiratory failure in asthma?
Silent chest (no air movement).
This is why an asthma patient is prescribed both a short-acting and a long-acting inhaler.
The short-acting inhaler treats acute bronchoconstriction, while the long-acting medication controls chronic inflammation and prevents future attacks.
SABA (quick relief) and LABA (inflammation reduction, daily control, and prevent exacerbation)
A patient has pH 7.30, CO₂ 65, HCO₃ 35. What is the interpretation?
Respiratory acidosis, partially compensated.
What is the purpose of the asthma action plan?
To guide the patient/family on steps to take based on symptoms/peak flow zones.
Asthma Action Plans provide specific instructions for green, yellow, and red zones. Helps patients know: when to use rescue inhaler, when to increase controller meds, when to call the provider, when to seek emergency care.
A COPD patient reports a sudden increase in sputum amount and a change from clear to yellow-green. This nursing action should be the priority.
Assess for respiratory infection and notify provider.
COPD patients are extremely vulnerable to pneumonia and flu. Handwashing, Avoiding crowds, and Vaccination reduces hospitalizations and exacerbations. Excellent prevention teaching before discharge
What are signs of infection? as opposed to exacerbation?
Name one sign of respiratory acidosis.
Confusion, drowsiness, hypoventilation, headache.
Why should a patient rinse their mouth after inhaled corticosteroids?
To prevent thrush (oral candidiasis).
A child with asthma takes a beta-blocker for migraines. What is the priority action?
Notify provider—medication can cause bronchoconstriction.
A nurse is caring for a client experiencing an acute asthma exacerbation. The client reports increasing shortness of breath, is using accessory muscles to breathe, and has audible wheezing. Vital signs show respiratory rate 32/min, oxygen saturation 88% on room air. Which nursing diagnosis is the priority for this client?
Ineffective Airway Clearance
Think of possible nursing diagnoses and what is evident through assessment. What is priority?
Possible: imbalanced nutrition, anxiety, activity intolerance, impaired tissue perfusion, impaired gas exchange, ineffective breathing pattern
Long-term smoking causes structural lung changes. Name one such change.
Loss of elasticity, destruction of alveoli, thickened airways, or increased mucus production.
Other Risks factors (cause COPD): career (occupational exposure), history of Asthma, environment/household, air pollution. Cigarette smoking is most significant cause.
A COPD patient becomes confused and somnolent. What ABG imbalance do you expect?
Respiratory acidosis with CO₂ retention
Why should non-selective beta-blockers be avoided in asthma?
They can cause bronchoconstriction and trigger asthma attacks.
A COPD patient’s ABG shows pH 7.37, CO₂ 55, HCO₃ 34. What does this indicate?
Fully compensated respiratory acidosis.