2. Definition :- Asthma is an intermittent, reversible,
obstructive airway disease, it is
manifested by a narrowing of airway resulting in
dyspnea, cough and wheezing.
Asthma can begin at any age about half of the
cases develop in childhood and anther third
before age 40.
Asthma is often characterized as allergic,
idiopathic Or mixed
Stress or emotional upset
Aspirin and non steroid anti-inflammatory chugs
(NSAlDs), beta-blockers (including eye drops),
cholinergic drugs (to promote bladder contraction and
as eye drops for glaucoma) .
Enzymes- including those in laundry detergents..
' Chemicals- toluene and others used in solvents,
paints, and plastics
4. The common symptoms of asthma are cough,
dyspnea & wheezing.
Asthma attacks frequently occur at
Attacks starts suddenly with coughing
& a sensation of tightness in the
Cyanosis secondary to sever hypoxia.
Symptoms of carbon dioxide retention
- sweating, tachycardia.
5. Un Status asthmatics occurs in which therapeutic
measures fail &the
patient has repeated attacks or continuous asthma.
Allergic reaction eczema, urticaria, edema.
6. 1-Acomplete history.
2- Reaction skin test.
3-Assessment of environmental factors, including
seasonal changes, mold and pollens. Climate
4-Occupation- related chemicals & compounds
(metal salts, wood & vegetable dust,
pharmacological a gents, industrial chemicals,
biologic enzymes - including laundry detergents 5-
6- Sputum examination.' Pulmonary function
7. There are five categories of drugs used in the
treatment of asthma:
Beta antagonist brortchodilatots:eg pinephrine.
Methylxanthines - bronchodilator e.g aminophylline
Ant cholinergic - broncho-dilatition effect e.g. tropine.
Corticosteroids - reduce inflammation & broncho-
constrictione.g. hydrocortisone prednisone.5- Mast
cell inhibitors: broncho-dilatition g.cromolyn sodium.
8. Assessment :-ASSESS THE PATIENT RFOR :-
History of asthma onset & duration
Medications used to relieve asthma symptoms
Any recent changes in medication regimen ,
Self-care methods used to relieve symptoms:
Assess General appearance.
Assess vital signs.
Assess laboratory findings.
9. Pneumonia is an inflammatory
illness of the lung. Frequently,
it is described as lung
inflammation and abnormal
alveolar filling with fluid
10. Classification according to the causative
1-' Bacterial pneumonia (common *
2- Viral Pneumonia
3- Mycoplasma Pneumonia
4-Aspiration pneumonia's syndrome
5-Chemical pneumonia, after ingestion
of kerosene or irritation gases
11. Risk factor/groups:
Patients with conditions that produce
bronchial obstruction -
Bed ridden patients
Very ill patients who are on nothing by
mouth ,Over dose of sedatives- respiratory
Associated with congestive heart failure
13. A lobar pneumonia is an infection that
only involves a single lobe, or section, of a
lung. Lobar pneumonia is often due to
Streptococcus pneumonia (though
Klebsiella pneumonia is also possible.)
Multilobar pneumonia involves more
than one lobe, and it often causes a more
14. pneumonia by clinical
them into characteristics, dividing
1-"acute" (less than three weeks
2- "chronic" pneumonias.
15. is infectious pneumonia in a person who
has not recently been hospitalized.
Streptococcus pneumonia is
the most common cause of
16. called Nosocomial
pneumonia, is pneumonia
acquired during or after
hospitalization for another
illness or procedure with
onset at least 72 hrs after
17. risk factors for pneumonia,
including mechanical ventilation,
prolonged malnutrition, underlying
heart and lung diseases,
decreased amounts of stomach
acid, and immune disturbances.
18. 1- Pneumonia arises from aspiration of
flora present in the oropharynx. &
blood borne organisms that enter the
2-An inflammatory reaction can occur
alveoli, producing exudates that in the
affect on ventilation 3-White blood
cells, mostly neutrophils, migrate into
the alveoli. Areas of the lung are not
adequately ventilated because of
secretions and mucosal edema that
cause partial occlusion of the bronchi
19. 4- Venous blood entering the
pulmonary circulation to the
left side of the heart poorly
oxygenated. The mixing of
oxygenated and unoxygenated
blood eventually results in
1-Cough producing greenish or yellow sputum,
2- high fever that may be accompanied by
shaking chills. 3- Shortness of breath4-
pleuritic chest pain, a sharp or stabbing pain,
either experienced during deep breaths or
coughs or worsened by them.
5- cough up blood, 6-headaches, or develop
sweaty and clammy skin.7- Other symptoms
are loss of appetite, fatigue, blueness of the
skin, nausea, vomiting, mood swings, and joint
pains or muscle aches.
21. 1-Medical intervention
Diagnosis:- patient's symptoms and
findings from physical examination,
chest X-ray and blood tests are
helpful, and sputum cultures chest CT
scan or other tests may be needed to
distinguish pneumonia from other
illnesses. A complete blood count
indicating the presence of an infection
or inflammation, in some people with
immune system problems
1-Administration of appropriate
antibiotics as Penicillin
Typically, oral antibiotics, rest,
fluids, and home care
2-people with other medical
problems and the elderly may need
treatment that is more advanced.
3-If the symptoms worse, the
pneumonia does not improve with
home treatment, or complications
occur, the person will often have to
1-treating underlying illnesses (such as
3-Testing pregnant women for Group B
Streptococcus and Chlamydia trachomatis,
and then giving antibiotic treatment
4 Suctioning the mouth and throat of
infants with meconium-stained amniotic
fluid decreases the rate of aspiration
5-Vaccination is important for preventing
pneumonia in both children and adults.
Vaccinations against Haemophilus
influenza and Streptococcus pneumonia in
the first year of life.
24. Assessment: .
The nurse should monitor the
• Changes in temperature and pulse
• Amount, odor, and color of secretions
• Frequency and severity of cough
• Degree of Tachypnea or shortness of
• Changes in physical assessment
findings (primarily assessed by
inspecting and auscultation the chest)
• Changes in the chest x-ray findings
25. NURSING DIAGNOSES
Based on the assessment data, the
patient’s major nursing diagnose smay
•1- Ineffective airway clearance related to
copious tracheobronchial secretions
•2- Activity intolerance related to impaired
• 3-Risk for deficient fluid volume related to
fever and dyspnea
• 4-Imbalanced nutrition: less than body
• 5-Deficient knowledge about the treatment
regimen and preventive health
26. Planning and Goals :-
The major goals for the patient may
include 1- improved airway
patency, rest to conserve energy,
2- maintenance of proper fluid
volume, maintenance of adequate
nutrition, 3- an understanding
treatment protocol and preventive
measures, 4- absence of
27. Nursing Interventions:-
1- IMPROVING AIRWAY PATENCY
2- PROMOTING REST AND CONSERVING
3- PROMOTING FLUID INTAKE
4- MAINTAINING NUTRITION
5- PROMOTING THE PATIENT’S
6- MONITORING AND MANAGING
7- PROMOTING HOME AND COMMUNITY-
BASED CARE &Teaching Patients
28. EXPECTED PATIENT OUTCOMES
a -Has normal vital signs, pulse oximetry,
and arterial blood gas measurements
b. Reports productive cough that
diminishes over time
c. Has absence of signs or
symptoms of shock, respiratory failure, or
d. Remains oriented and aware of
e. Maintains or increases weight
8. Complies with treatment protocol and