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Asthma NCLEX Questions

This is a quiz that contains NCLEX review questions for asthma . Asthma is a chronic respiratory disease that causes inflammation to the smaller airways.

In the previous NCLEX review series , I explained about other respiratory disorders, so be sure to check those reviews out.

As the nurse, it is important to know how to care for a patient with asthma. In addition, the nurse needs to be aware of the triggers, warning signs, medications used to treat, and patient management for asthma.

Don’t forget to watch the lecture on asthma before taking this quiz.

This quiz contains NCLEX practice questions about asthma.

A. The patient inhales the Salmeterol first and then waits 5 minutes before inhaling the Fluticasone.

B. The patient inhales the Fluticasone first and then waits 5 minutes before inhaling the Salmeterol.

C. The patient inhales the Salmeterol first and then waits 1 minute before inhaling the Fluticasone.

D. The patient inhales the Fluticasone and immediately inhales the Salmeterol.

A. Theophylline

B. Tiotropium

C. Albuterol

D. Cromolyn

A. Peak flow meter; pneumonia

B. Incentive spirometer; thrush

C. Spacer; thrush

D. Peak flow meter; mouth sores

A. Immediately stop the nebulizer

B. Re-adjust the nebulizer

C. Call a rapid response because the patient is having a potential anaphylactic reaction to the medication.

D. Reassure the patient this is a temporary side effect of this medication.

A. Montelukast

B. Omalizumab

C. Cromolyn

D. Salmeterol

A. Easily fatigued with physical activity

B. Reduced peak flow meter reading

C. Chest retractions

D. Cyanosis

E. Wheezing with activity

F. Nighttime coughing

G. No relief with short-acting bronchodilator inhaler

A. The smooth muscle surrounding the alveoli constricts, limiting oxygenation.

B. The mucosa lining experiences severe inflammation.

C. The goblet cells within the mucosa lining produce excessive amounts of mucous.

D. Too much carbon dioxide is exhaled due to hyperventilation and the patient experiences respiratory alkalosis.

• A. "This device will help keep my lungs strong so I don't have another asthma attack."
• B. "I will inhale as hard as I can while using the device."
• C. "I will use this device at the same time, either in the morning or before bedtime, and compare the readings with my personal best reading."
• D. "I will notify the doctor if my peak flow rating is 90% or more than my personal best peak flow."

A. Sulfites

C. Caffeine

E. Cold, windy weather

F. Beta agonist

G. Cockroaches

A. Avoid warming up before exercise.

B. Administer a short-acting beta agonist before exercise.

C. Administer a short-acting beta agonist after exercise.

D. Avoid exercising when experiencing a respiratory illness.

A. Caffeine

D. Shellfish

A. Salmeterol

B. Theophylline

C. Tiotropim

D. Montelukast

A. Intravenous

B. Intramuscular

D. Subcutaneously

A. Bradycardia

B. Tachycardia

C. Drowsiness

D. Feeling cold

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You can get an eBook version here or a physical copy of the book here.

1. A patient with asthma is prescribed to take inhaled Salmeterol and Fluticasone for long-term management of asthma. You observe the patient taking these medications. Which option below best describes the correct order in how to take these medications?

The answer is A. The bronchodilator inhaler (Salmeterol) is administered first to open up the airways. Then the patient is to wait five minutes and then administer the corticosteroid (Fluticasone). The bronchodilator will open the airways so the corticosteroid can easily enter the airways to decrease inflammation.

2. You’re assisting your patient who has asthma to bed. The patient is experiencing a frequent cough and chest tightness. You auscultate the patient’s lung fields and note expiratory wheezes. The patient’s peak flow rate is 78% less than their best peak flow reading. Which medication will provide the patient with the fastest relief from these signs and symptoms of an asthma attack?

The answer is C. During an asthma attack, the patient needs a medication that will quickly open the airways. Medications that are best for this include short-acting bronchodilators, such as Albuterol, short-acting beta agonists. Another type of short-acting bronchodilator is an anticholinergic bronchodilator called Ipratropium (this is given if a patient can’t tolerated short-acting beta agonists like Albuterol). Theophylline is a bronchodilator but given orally and is NOT for quick relief. Tiotropium is a bronchodilator, as well, but is a LONG-ACTING anticholinergic bronchodilator. Cromolyn is an inhaled nonsteroidal anti-allergy medication that doesn’t provide quick relief.

3. You assist your patient with using their inhaler. The inhaler contains the medication Budesonide. Before administering the inhaler, you will want to connect what device to the inhaler to help decrease the patient from developing ________?

The answer is C. Budesonide is a corticosteroid. Inhaled corticosteroids can cause thrush. Therefore, it is important to connect a spacer to the inhaler before usage to help prevent the patient from developing thrush and for the patient to gargle and rinse the mouth with water.

4. A patient with asthma is receiving a nebulizer of Cromolyn. The patient reports a burning sensation in the nose along with a horrible taste in their mouth. As the nurse you will?

The answer is D. Cromolyn can temporarily cause the following side effects during administration: sneezing, burning in nose, itchy/watery eyes, bad taste in mouth. Reassure the patient that these are temporary side effects of this medication.

5. Your patient’s asthma is poorly controlled. The patient reports using their rescue inhaler 4 times a week. In addition, the patient’s asthma is not responding to other treatments. The physician orders the patient to take a medication that works by blocking the role of the immunoglobulin IgE. This describes which medication below?

The answer is B. Omalizumab blocks the role of the immunoglobulin IgE, which will decrease the allergic response…hence asthma attacks. It is given subcutaneously and used when a patient’s asthma is poorly controlled and other treatments are not working. It is NOT used for quick relief. It is important the patient receives NO LIVE vaccines while receiving this medication.

6. You’re providing discharge teaching to a patient who was admitted with asthma. You discussed the early warning signs of an asthma attack and ask the patient to list some of them. Select all the correct early warning signs verbalized by the patient:

The answers are A, B, E, and F. These are all early warning signs an asthma attack is imminent. Options C, D, and G are signs and symptoms of an active asthma attack that requires medical treatment.

7. Select all the correct options that represent the pathophysiology of an asthma attack.

The answers are B and C. Option A is wrong because the smooth muscle surrounding the BRONCHI AND BRONCHIOLES CONSTRICTS (not alveoli), limiting oxygenation. Option D is wrong become the patient does NOT experience respiratory alkalosis but respiratory ACIDOSIS. During an asthma attack, the patient is unable to exhale fully and air trapping occurs. Therefore, gas exchange does NOT occur, leaving carbon dioxide to build up in the blood and NO oxygen to enter the bloodstream. The CO2 builds up in the system and oxygen saturations drop….hence acidosis. Remember CO2 is acidic.

8. You’re educating a patient how to use a peak flow meter to help monitor the status of their asthma. Which statement by the patient demonstrates they understand how to use the device?

A. “This device will help keep my lungs strong so I don’t have another asthma attack.”

B. “I will inhale as hard as I can while using the device.”

C. “I will use this device at the same time, either in the morning or before bedtime, and compare the readings with my personal best reading.”

D. “I will notify the doctor if my peak flow rating is 90% or more than my personal best peak flow.”

The answer is C. This option is correct. Option A is wrong because this device monitors how controlled a patient’s asthma is and if it is getting worst. It doesn’t make the lung stronger. Option B is wrong because the patient exhales as hard as they can onto the device. Option D is wrong because a flow rate of 90% of the personal best peak flow is a good reading.

9. Select all the following that can trigger an asthma attack:

The answers are A, B, D, E, and G. Caffeine has the same properties as theophylline, which is a bronchodilator and is not known to cause asthma. In addition, beta adrenergic blockers that are nonselective (NOT beta agonist…which are used to treat asthma) can cause an asthma attack.

10. A patient has exercise-induced asthma. Which of the following actions can the patient perform to help prevent an attack during exercise. Select all that apply:

The answer are B and D. Option A is wrong because the patient should warm up for at least 10-15 minutes before exercising, and option C is wrong because the beta agonist should be administered BEFORE exercise (not after).

11. Your patient with asthma is taking Theophylline. Which product below should the patient avoid consuming?

The answer is A. Caffeine has the same properties as Theophylline and can increase the effects the drug.

12. Which medication below blocks the function of Leukotriene for the treatment of asthma?

The answer is D.

13. The physician orders the patient to start taking Omalizumab. How will you administer this medication as the nurse?

14. A patient received a nebulizer of Albuterol. What is a side effect of this medication?

The answer is B.

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Asthma Case Study

Asthma affects about 6.1 million children in the US under 18 years of age, making it one of the most common chronic childhood disorders (American Lung Association, 2021). Asthma occurs as a result of a stimulus which can range from allergens, cigarette smoke, changes in temperature, stress, or exercise. In this case we’ll experience an asthma attack and subsequent treatment with 16-year-old Ben Mason.

Module 9: Asthma

Review structure and functions of the respiratory system...

Asthma - Page 1

Ben was struggling to breathe when he reached the ER...

Asthma - Page 2

Ben was also given an additional breathing treatment...

Asthma - Page 3

Case Summary

Summary of the Case

Asthma - Summary

Answers to Case Questions

Asthma - Answers

Professionals

Health Professionals Introduced in Case

Asthma - Professionals

Additional Links

Asthma - Links

Nursing Case Study for Pediatric Asthma

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Anthony is a 6-yr-old male patient brought to the pediatric ER with a history of asthma since he came home from the NICU as an infant. He lives with his parents, Bob and Josh, who adopted him after fostering him from age 4 months. They have tried the usual nebulizer treatments but Anthony is not responding as usual, so they brought him for evaluation.

Initial assessment in triage reveals both inspiratory and expiratory wheezes, dyspnea, tachypnea, diaphoresis, and retractions.

BP 70/40 mmHg SpO2 93% on room air HR 131 bpm RR 32bpm at rest Temp 38.3°C

What physiologic issue is Anthony suffering from based on the assessment findings?

• Respiratory distress is evidenced by both vital signs and physical assessment findings. His RR and HR are high. He is also sweating and having retractions which may indicate he is working hard to try to establish oxygen exchange.

What signs and symptoms might occur that would show worsening of his condition?

• Skin color changes (i.e. blue or bluish around the mouth or even inside the mouth, blue nail beds, gray or pale compared to usual)
• Grunting on exhalation (this indicates the body is trying to keep air in the lungs)
• Stridor (this is heard in the upper airway and can be an ominous sign)
• Changes in the level of consciousness (becoming lethargic or drowsy)

Anthony is pale but not gray. His lips do indicate a very faint bluish tinge. He can speak but it appears difficult.

What medications might the nurse expect the provider to order?

• Short-acting beta-agonists (SABAs)
• Racemic albuterol – A racemic mixture of albuterol (salbutamol) is the primary SABA used for quick relief of acute asthma symptoms and exacerbations.
• Levalbuterol – Levalbuterol (Levosalbutamol), the R-enantiomer, is the active isomer of racemic albuterol that confers the bronchodilator effects. Levalbuterol is approved in the United States for the treatment of bronchospasm in children ≥4 years of age via hydrofluoroalkane (HFA) metered-dose inhaler (MDI) and ≥6 years of age via solution for nebulizer

What side effects might occur from the medications ordered?

• “The most common side effects are tremor, increased heart rate, and palpitations” Anthony may report feeling jittery due to the activation of beta receptors.

After administration of racemic albuterol, Anthony now has a RR of 22 and O2 saturation of 95% on room air. However, the provider decides to admit him to the inpatient pediatric observation unit. His parents ask if there are ways to keep him from continually being admitted to the hospital.

What are some education topics to bring up to Anthony’s parents?

• Controlling asthma triggers — The factors that set off or worsen asthma symptoms are called “triggers.” Identifying and avoiding asthma triggers is essential to keeping symptoms under control. Common asthma triggers generally fall into several categories:
• Allergens (including dust mites, pollen, mold, cockroaches, mice, cats, and dogs)
• Respiratory infections, such as the common cold or the flu
• Irritants (such as tobacco smoke, chemicals, and strong odors or fumes)
• Exercise or other physical activity

What does the nurse understand about this medication?

• Systemic corticosteroids are an essential treatment option for many disease states, especially asthma. These medications reduce the length and severity of asthma exacerbations and reduce the need for hospitalization or ED visits. It is important for asthma patients to receive prednisolone as soon as possible after the onset of symptoms that are bronchodilator-unresponsive to attain these benefits.
• Although usually prescribed for a 5- to 7-day period, oral corticosteroids are not without adverse effects. The most common adverse effects are the same for the majority of oral corticosteroids and include increased appetite, weight gain, flushed face.
• Increased risk of infections, especially with common bacterial, viral and fungal microorganisms. Thinning bones (osteoporosis) and fractures happen over time, be mindful this may cause problems in an energetic child. Suppressed adrenal gland hormone production may result in a variety of signs and symptoms, including severe fatigue, loss of appetite, nausea and muscle weakness.

Anthony sleeps during the night shift and the next day, his pediatrician makes rounds and discusses a change in the severity rating of Anthony’s asthma.

What does the nurse know about asthma severity and how it is determined?

• Asthma severity is the intrinsic intensity of the disease. Assessment of asthma severity is made on the basis of components of current impairment and future risk. The severity is determined by the most severe category measured

Bob and Josh are interested in meeting with respiratory therapy for assistance with inhalers. They say that Anthony has trouble using inhaler devices.

Inviting respiratory therapy to provide parent teaching is an example of what? How can this department help the family?

• Interdisciplinary team collaboration.
• Teaching about medications, proper inhaler (or other equipment) use, thorough explanation of peak expiratory flow (PEF) measuring, ways to help control RR.

After lunch, Anthony is ready to be discharged. His parents verbalize gratitude to the staff and thank the team for helping with education.

What can the nurse help Bob and Josh start to establish to try to help them with Anthony’s condition?

• Setting goals and planning. Preparing for an action plan (“Asthma ‘action plan’ is a form or document that your child’s provider can help you put together; it includes instructions about how to monitor symptoms and what to do when they happen. Asthma action plans are available for children up to five years old, for children five years and older and adults and for school. An action plan can tell you when to add or increase medications, when to call your child’s provider, and when to get immediate emergency help. This can help you know what to do in the event of an asthma attack. Different people can have different action plans, and your child’s action plan will likely change over time.”) 

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This nursing case study course is designed to help nursing students build critical thinking.  Each case study was written by experienced nurses with first hand knowledge of the “real-world” disease process.  To help you increase your nursing clinical judgement (critical thinking), each unfolding nursing case study includes answers laid out by Blooms Taxonomy  to help you see that you are progressing to clinical analysis.We encourage you to read the case study and really through the “critical thinking checks” as this is where the real learning occurs.  If you get tripped up by a specific question, no worries, just dig into an associated lesson on the topic and reinforce your understanding.  In the end, that is what nursing case studies are all about – growing in your clinical judgement.

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Asthma attack

When a person has asthma, the inside walls of the airways in the lungs can narrow and swell. Also, the airway linings may make too much mucus. The result is an asthma attack. During an asthma attack, narrowed airways make breathing difficult and may cause coughing and wheezing.

Asthma is a condition in which your airways narrow and swell and may produce extra mucus. This can make breathing difficult and trigger coughing, a whistling sound (wheezing) when you breathe out and shortness of breath.

For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack.

Asthma can't be cured, but its symptoms can be controlled. Because asthma often changes over time, it's important that you work with your doctor to track your signs and symptoms and adjust your treatment as needed.

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Asthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times — such as when exercising — or have symptoms all the time.

Asthma signs and symptoms include:

• Shortness of breath
• Chest tightness or pain
• Wheezing when exhaling, which is a common sign of asthma in children
• Trouble sleeping caused by shortness of breath, coughing or wheezing
• Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu

Signs that your asthma is probably worsening include:

• Asthma signs and symptoms that are more frequent and bothersome
• Increasing difficulty breathing, as measured with a device used to check how well your lungs are working (peak flow meter)
• The need to use a quick-relief inhaler more often

For some people, asthma signs and symptoms flare up in certain situations:

• Exercise-induced asthma, which may be worse when the air is cold and dry
• Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust
• Allergy-induced asthma, triggered by airborne substances, such as pollen, mold spores, cockroach waste, or particles of skin and dried saliva shed by pets (pet dander)

When to see a doctor

Seek emergency treatment.

Severe asthma attacks can be life-threatening. Work with your doctor to determine what to do when your signs and symptoms worsen — and when you need emergency treatment. Signs of an asthma emergency include:

• Rapid worsening of shortness of breath or wheezing
• No improvement even after using a quick-relief inhaler
• Shortness of breath when you are doing minimal physical activity

Contact your doctor

See your doctor:

• If you think you have asthma. If you have frequent coughing or wheezing that lasts more than a few days or any other signs or symptoms of asthma, see your doctor. Treating asthma early may prevent long-term lung damage and help keep the condition from getting worse over time.
• To monitor your asthma after diagnosis. If you know you have asthma, work with your doctor to keep it under control. Good long-term control helps you feel better from day to day and can prevent a life-threatening asthma attack.

If your asthma symptoms get worse. Contact your doctor right away if your medication doesn't seem to ease your symptoms or if you need to use your quick-relief inhaler more often.

Don't take more medication than prescribed without consulting your doctor first. Overusing asthma medication can cause side effects and may make your asthma worse.

• To review your treatment. Asthma often changes over time. Meet with your doctor regularly to discuss your symptoms and make any needed treatment adjustments.

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It isn't clear why some people get asthma and others don't, but it's probably due to a combination of environmental and inherited (genetic) factors.

Asthma triggers

Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:

• Airborne allergens, such as pollen, dust mites, mold spores, pet dander or particles of cockroach waste
• Respiratory infections, such as the common cold
• Physical activity
• Air pollutants and irritants, such as smoke
• Certain medications, including beta blockers, aspirin, and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve)
• Strong emotions and stress
• Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine
• Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat
• Asthma and acid reflux

Risk factors

A number of factors are thought to increase your chances of developing asthma. They include:

• Having a blood relative with asthma, such as a parent or sibling
• Having another allergic condition, such as atopic dermatitis — which causes red, itchy skin — or hay fever — which causes a runny nose, congestion and itchy eyes
• Being overweight
• Being a smoker
• Exposure to secondhand smoke
• Exposure to exhaust fumes or other types of pollution
• Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing

Complications

Asthma complications include:

• Signs and symptoms that interfere with sleep, work and other activities
• Sick days from work or school during asthma flare-ups
• A permanent narrowing of the tubes that carry air to and from your lungs (bronchial tubes), which affects how well you can breathe
• Emergency room visits and hospitalizations for severe asthma attacks
• Side effects from long-term use of some medications used to stabilize severe asthma

Proper treatment makes a big difference in preventing both short-term and long-term complications caused by asthma.

While there's no way to prevent asthma, you and your doctor can design a step-by-step plan for living with your condition and preventing asthma attacks.

Follow your asthma action plan. With your doctor and health care team, write a detailed plan for taking medications and managing an asthma attack. Then be sure to follow your plan.

Asthma is an ongoing condition that needs regular monitoring and treatment. Taking control of your treatment can make you feel more in control of your life.

• Get vaccinated for influenza and pneumonia. Staying current with vaccinations can prevent flu and pneumonia from triggering asthma flare-ups.
• Identify and avoid asthma triggers. A number of outdoor allergens and irritants — ranging from pollen and mold to cold air and air pollution — can trigger asthma attacks. Find out what causes or worsens your asthma, and take steps to avoid those triggers.

Monitor your breathing. You may learn to recognize warning signs of an impending attack, such as slight coughing, wheezing or shortness of breath.

But because your lung function may decrease before you notice any signs or symptoms, regularly measure and record your peak airflow with a home peak flow meter. A peak flow meter measures how hard you can breathe out. Your doctor can show you how to monitor your peak flow at home.

Identify and treat attacks early. If you act quickly, you're less likely to have a severe attack. You also won't need as much medication to control your symptoms.

When your peak flow measurements decrease and alert you to an oncoming attack, take your medication as instructed. Also, immediately stop any activity that may have triggered the attack. If your symptoms don't improve, get medical help as directed in your action plan.

• Take your medication as prescribed. Don't change your medications without first talking to your doctor, even if your asthma seems to be improving. It's a good idea to bring your medications with you to each doctor visit. Your doctor can make sure you're using your medications correctly and taking the right dose.
• Pay attention to increasing quick-relief inhaler use. If you find yourself relying on your quick-relief inhaler, such as albuterol, your asthma isn't under control. See your doctor about adjusting your treatment.
• Weinberger SE, et al. Asthma. In: Principles of Pulmonary Medicine. 7th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed March 30, 2020.
• Asthma. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/asthma. Accessed March 25, 2020.
• AskMayoExpert. Asthma (adult). Mayo Clinic; 2020.
• Global strategy for asthma management and prevention (2019 update). Global Initiative for Asthma. https://ginasthma.org/gina-reports/. Accessed March 27, 2020.
• Khurana S, et al. Systematic approach to asthma of varying severity. Clinics in Chest Medicine. 2019; doi:10.1016/j.ccm.2018.10.004.
• Ferri FF. Asthma. In: Ferri's Clinical Advisor 2020. Elsevier; 2020. https://www.clinicalkey.com. Accessed March 30, 2020.
• Wu TD, et al. Asthma in the primary care setting. Medical Clinics of North America. 2019; doi:10.1016/j.mcna.2018.12.004.
• Fanta CH. An overview of asthma management. https://www.uptodate.com/contents/search. Accessed March 30, 2020.
• Santino TA, et al. Breathing exercises for adults with asthma. Cochrane Database of Systematic Reviews. 2020; doi:10.1002/14651858.CD001277.pub4.
• Amaral-Machado L, et al. Use of natural products in asthma treatment. Evidence-based Complementary and Alternative Medicine. 2020; doi:10.1155/2020/1021258.
• Montelukast. IBM Micromedex. https://www.micromedexsoluitions.com. Accessed April 6, 2020.
• Whyand T, et al. Pollution and respiratory disease: Can diet or supplements help? A review. Respiratory Research. 2018; doi:10.1186/s12931-018-0785-0.
• O'Keefe JH, et al. Coffee for cardioprotection and longevity. Progress in Cardiovascular Diseases. 2018; doi:10.1016/j.pcad.2018.02.002.
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Asthma Attack!

By Hollie L. Leavitt

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This interrupted case study follows the progress of a pediatric patient who experiences an acute asthma exacerbation brought on by an environmental trigger.  Students completing the case will synthesize their understanding of respiratory system anatomy and physiology with the clinical treatment of an obstructive lung disorder.  Topics reviewed include bronchoconstriction and dilation, pulmonary ventilation, air flow, gas exchange, respiratory volumes, the oxygen-hemoglobin dissociation curve, pCO2, pO2, and the effects of medications used to treat asthma.  Students should have an understanding of the respiratory system before starting the case and thus it is best used at the end of the respiratory system unit as a way for students to apply what they have learned to a real-world situation.  The case was developed for an anatomy and physiology class for majors taught through the “flipped” method at a community college, but would also work well for students in a pathophysiology course or in pre-professional programs in health care.  It may also be suitable for high school students in an advanced or honors anatomy and physiology program.

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• Describe the anatomy of the respiratory passageways.
• Understand respiratory system function including air flow and gas exchange.
• Determine the effects of bronchoconstriction and bronchodilation on air flow.
• Describe the pressure gradients required for pulmonary ventilation.
• Understand respiratory volumes and how they are used clinically to assess disease.
• Know how to use the oxygen-hemoglobin dissociation curve.
• Predict how pCO2 and pO2 are affected by an obstructive lung disease.
• Describe pathological changes in the airways and environmental factors that can lead to an acute asthma exacerbation.
• Understand the effects of some of the medications used to treat asthma.

asthma; respiratory anatomy; respiratory physiology; respiratory system; lung pathology; respiratory volumes; oxygen-hemoglobin dissociation;

Subject Headings

EDUCATIONAL LEVEL

High school, Undergraduate lower division, Undergraduate upper division, Professional (degree program)

TOPICAL AREAS

TYPE/METHODS

Teaching Notes & Answer Key

Teaching notes.

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Materials & Media

Supplemental materials.

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The PowerPoint presentation below includes optional slides for in-class review before presenting the case.

• asthma_attack_sup.ppt (~634 KB)
• How Does Asthma Work? This animated video gives an overview of asthma, including why people get it, and how it can be deadly. Running time: 5:09 min. Produced by TED-Ed, 2017.

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• Take the Asthma Quiz

Información disponible en español

1. What is an asthma attack?

2. true or false: asthma can be cured., 3. which of the following are potential asthma triggers, 4. what can you do to reduce asthma triggers in your home, 5. true or false: secondhand smoke increases the risk of preschool-aged children developing asthma..

The correct answer is B.

When airways tighten and the lungs don't get enough air. Read more asthma facts (PDF) (36 pp, 1 MB, About PDF ) .

The correct answer is False.

Asthma is a serious, sometimes life-threatening chronic respiratory disease. Although there is no cure for asthma yet, it can be controlled through medical treatment and management of environmental triggers. Learn more about asthma and the indoor environment .

The correct answer is All of the above.

Asthma attacks can be triggered by tiny dust mites, molds, pet dander, secondhand smoke and even cockroaches. Learn more about other indoor irritants that can be asthma triggers .

Check out EPA’s new PSA featuring the Breathe Easies , who educate parents and children with asthma about simple steps to prevent asthma attacks. Read more about pests, pesticides and public health.

The correct answer is True.

Secondhand smoke is a risk factor for new cases of asthma in preschool-aged children. Secondhand smoke can also trigger asthma episodes and increase the severity of attacks. Children's developing bodies make them more susceptible to the effects of secondhand smoke and, due to their small size, they breathe more rapidly than adults, thereby taking in more secondhand smoke. Take action and ensure children are not exposed to secondhand smoke .

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• Indoor Air Quality Home Page
• Asthma Home
• Resources about Asthma
• Publications about Asthma
• Asthma Frequently Asked Questions
• Asthma Triggers
• Develop an Asthma Action Plan
• Asthma Awareness
• Asthma in Communities and Schools
• National Asthma Awards
• Federal and Partner Organizations
• Public Service Announcements & Multimedia

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• Download Chapter PDF

Disclaimer: These citations have been automatically generated based on the information we have and it may not be 100% accurate. Please consult the latest official manual style if you have any questions regarding the format accuracy.

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Pathophysiology, epidemiology, risk factors, clinical presentation.

• DESIRED OUTCOMES
• TREATMENT: GENERAL APPROACH
• TREATMENT: NONPHARMACOLOGIC THERAPY
• TREATMENT: PHARMACOLOGIC THERAPY
• ADDITIONAL RESOURCES
• Full Chapter
• Supplementary Content

Source : Sorkness CA, Blake KV. Asthma. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach . 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861&sectionid=146058008 . Accessed April 13, 2017.

Chronic inflammatory disorder of airways that causes recurrent episodes of wheezing, breathlessness, chest tightness, and coughing.

Genetic factors.

Environmental exposures (see Risk Factors)

Major characteristics:

Airflow obstruction (related to bronchospasm, edema, and hypersecretion)

Bronchial hyperresponsiveness (BHR)

Airway inflammation.

Inhaled allergen causes activation of B lymphocytes, mast cells, and macrophages, which release proinflammatory mediators such as histamine and eicosanoids that induce contraction of airway smooth muscle, mucus secretion, vasodilation, exudation, and edema with reduced mucus clearance.

Activation of eosinophils, T lymphocytes, basophils, neutrophils, and macrophages cause further release of inflammatory mediators such as leukotrienes, interleukins, histamine, platelet-activating factor (PAF), and chemotactic factors.

Affects 25.7 million persons in the United States.

Most common chronic childhood disease, affecting approximately 7 million children.

Accounts for 1.6% of ambulatory care visits (10.6 million physician office visits and 1.2 million hospital outpatient visits).

Resulted in 479,000 hospitalizations and 2.1 million emergency department (ED) visits in 2009.

Accounts for >14.4 million missed school days per year.

Genetic predisposition.

Socioeconomic status.

Family size.

Exposure to secondhand tobacco smoke in infancy and in utero.

Allergen exposure.

Ambient air pollution.

Urbanization.

Respiratory syncytial virus (RSV) and rhinovirus infection.

Decreased exposure to common childhood infectious agents.

SIGNS AND SYMPTOMS

Chronic asthma.

Symptoms: Episodic dyspnea with wheezing, chest tightness, and coughing that may occur spontaneously, with exercise, or after exposure to known allergens.

Signs: Expiratory wheezing; dry, hacking cough; atopy (eg, allergic rhinitis, eczema)

Can vary in frequency from intermittent to chronic daily symptoms.

Severity determined by lung function, symptoms, nighttime awakenings, and interference with normal activity.

Acute severe asthma.

Symptoms: Anxiousness with acute distress and complaints of severe dyspnea, shortness of breath, and chest tightness unresponsive to usual measures.

Signs: Expiratory and inspiratory wheezing; dry, hacking cough; tachypnea; tachycardia; pallor or cyanosis; hyperinflated chest with intercostal and supraclavicular retractions.

MEANS OF CONFIRMATION AND DIAGNOSIS

History of recurrent episodes of coughing, wheezing, chest tightness, or shortness of breath and confirmatory spirometry.

May be family history of allergy or asthma, or patient symptoms of allergic rhinitis.

History of exercise or cold air precipitating symptoms during specific allergen seasons.

History of previous asthma exacerbations (eg, hospitalizations, intubations) and complicating illnesses (eg, cardiac disease, diabetes).

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