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Pathophysiology: Risk Factors

Status asthmaticus is a medical emergency characterized by severe, uncontrolled asthma that can lead to respiratory failure. It occurs when an asthma exacerbation is not adequately treated. The pathophysiology involves severe airflow obstruction, incomplete exhalation, increased lung volume, and expanded small airways, potentially progressing to hyperinflation and respiratory failure if not properly managed. Nurses prioritize interventions to prevent suffocation, fluid imbalance, and respiratory acidosis through measures such as oxygen administration, monitoring, positioning, bronchodilators, corticosteroids, IV fluids, and correcting electrolyte abnormalities.

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178 views4 pages

Pathophysiology: Risk Factors

Status asthmaticus is a medical emergency characterized by severe, uncontrolled asthma that can lead to respiratory failure. It occurs when an asthma exacerbation is not adequately treated. The pathophysiology involves severe airflow obstruction, incomplete exhalation, increased lung volume, and expanded small airways, potentially progressing to hyperinflation and respiratory failure if not properly managed. Nurses prioritize interventions to prevent suffocation, fluid imbalance, and respiratory acidosis through measures such as oxygen administration, monitoring, positioning, bronchodilators, corticosteroids, IV fluids, and correcting electrolyte abnormalities.

Uploaded by

Edson John Demayo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Topic: Status Asthmaticus

Status asthmaticus is considered a medical emergency. It is the extreme form of an


asthma exacerbation that can result in hypoxemia, hypercarbia, and secondary
respiratory failure. In practice, the role of the physician is to prevent this from
happening through patient compliance with controller medications (eg, steroid
inhalers) in an outpatient setting.

Pathophysiology

Severe Airflow
obstruction

Incomplete exhalation

Increased Lung Volume

Expanded small airways

Decreased Expiratory
Resistance

Compensated
Hyperinflation

Normocapnia

Decompensated:

Severe Hyperinflation,

Risk Factors:

 Respiratory infections
 Severe stress
 Cold weather
 Severe allergic reactions
 Air pollution
 Exposure to chemicals and other irritants
 Smoking

Signs and Symptoms:

 Short shallow breaths


 Wheezing
 Coughing
 Difficulty breathing
 Heavy Sweating
 Trouble Speaking
 Fatigue and weakness
 Abdominal,back,or neck muscle pain
 Panic or confusion
 Blue-tinted lips or skin
 Loss of consciousness

Prioritized Nursing Intervention

Nursing Diagnosis Nursing Intervention Rationale


Risk for suffocation r/t Independent: 1. To maintain satisfactory
bronchospasm,mucus 1. Administer humidified O2 by oxygenation.
tent, facemask or cannula.
secretions and edema. 2. To detect early or
2. Closely monitor O2 sat and impending hypoxia.
ABG via pulse oximetry.

3. Closely monitor percentage 3. High levels may depress


of O2 delivered. respirations.

4. Establish IV infusion.
1. For administration of meds
and hydration.

5. Position patient high fowlers, 5. This position is more


provide overbed table pillows on comfortable for a child.
which to lean. Promotes lung expansion.

6. Closely monitor vital signs 6. To promote maximum


before, during and after drug efficacy and minimal side
administration. effects.

7. Interview the parent to 7. To avoid possible overdose.


determine medications given
before admission.

8. Have emergency equipment 8. To prevent delay in tx.


and medications readily
available.
Dependent:
1. Administer aerosolized 1. To relieve bronchospasm.
bronchodilators and either
oral/IV costicosteroids as
prescribed

Nursing Diagnosis Nursing Intervention Rationale


Risk for fluid volume Independent: 1. Liquid therapy will enhance
deficit r/t difficulty taking 1. Maintain IV infusion at liquefaction of secretions.
fluids, insensible loses appropriate rate ( IV @2/3 to ¾
from hyporventilation and to minimize risk of pulmonary
diaphoresis. edema because of high
inspiratory pressure).
2. To correctly monitor for true
2. Monitor I and O. fluid volume deficits or other
underlying disorder.

3. Overhydration can increase


pulmonary fluid leading to
increased airway obstruction.
3. Correct dehydration slowly.
4. To decrease risk for
aspiration.

5. They can trigger reflex


4. Encourage oral fluids when bronchospasm.
ARD subsides.

5. Avoid cold liquids.

Nursing Diagnosis Nursing Intervention Rationale


Risk for injury (resp. Independent:
acidosis, electrolyte 1. Closely monitor blood pH. 1. Blood pH <7.25 impairs
imbalance) r/t systemic, pulmonary and
hypoventilation and coronary blood flow. Normal
dehydration. ph enhances effect of
bronchodilators.

2. For administration of
2. Maintain IV infusion. emergency meds and to
prevent DHN.

3. Initially child will experience


3. Prevent vomiting and alkalosis but if vomiting
subsequent DHN. becomes severe/ uncontrolled
it can lead to acidosis.

4. Hypoventilation may cause


an accumulation of CO2 which
will decrease pH.
4. Implement measures to
improve ventilation.

1. To prevent/ correct acidosis.

Dependent:

1. Administer sodium
bicarbonate as ordered.

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