A Guide to Determining an Asthma Nursing Diagnosis and Creating a Care Plan

Recognizing signs and symptoms of asthma can help nurses diagnose the problem and create the right care plan for patients. Asthma can be very dangerous to people of all ages when not treated or managed correctly. Thankfully, there are tools and resources nurses can offer patients to help limit risk.

This article discusses what asthma is, its causes, signs and symptoms, and care plans to treat patients.

What is asthma?

Asthma is a common chronic health condition affecting the respiratory system. A person with asthma can experience breathing difficulty, coughing, wheezing, and shortness of breath due to swelling, narrowing, and possible added mucus production in the airway.

Certain risk factors can increase the likelihood of developing asthma. However, the prognosis is good with the medical management of symptoms. Certain medications can treat bronchial inflammation and improve oxygen and carbon dioxide gas exchange in the bloodstream.

These medications include:

• Daily corticosteroids
• Anti-inflammatory anticholinergics
• Theophylline
• Short-acting beta 2-agonist, Albuterol

Some patients may experience side effects from asthma control medications.

The most common include:

• Increased heart rate
• Impaired growth in pediatric patients
• Sore throat
• Dysphonia or hoarseness

Asthma nursing diagnosis

There are several techniques used to show evidence of asthma in patients.

The most popular techniques include:

• Physical exam
• Auscultation of the lungs, including breathing and lung sounds
• Spirometry
• Arterial blood gas (ABG) testing
• Chest X-ray

An intake of personal history during the initial assessment can provide a clearer picture of the cause of asthma. A collection of signs and symptoms can help nurses diagnose asthma.

Causes of asthma

Several factors can put someone at risk of developing this chronic disease.

• Genetics and environment: These can play a role in increasing asthma risk. For instance, exposure to tobacco smoke in utero or as a child can increase the chances of asthma.
• Childhood illness: Sickness, such as bronchiolitis, can also increase risk.
• Atopic conditions: This includes things like eczema, hay fever, and food allergies.
• Physical activity or exercise: Asthmatic flares can also occur in certain situations. For some, exercise may induce asthma symptoms. This activity intolerance can affect airflow to the lungs and cause difficulty breathing.
• Workplace irritants: Certain occupations may place employees at a higher risk of developing asthma. Several chemicals can trigger mild to severe symptoms.
• Seasonal changes: Certain aspects of seasonal changes can also bring asthma symptoms. Outdoor allergens can cause sneezing, shortness of breath, and bronchoconstriction.
• Indoor allergens: Things like dust mites or pet dander can bring on an asthma attack.

A variety of factors may cause asthma. With a full assessment, health care providers can help patients narrow down environmental triggers and provide suggestions on how to best minimize exposure.

Asthma signs and symptoms

Asthma symptoms and signs can range from mild to life-threatening.

Asthma signs and symptoms include:

• Dyspnea or shortness of breath
• Chest tightness
• Retraction when inhaling
• Wheezing upon exhale

During a severe asthma attack (called asthma exacerbation), a person may exhibit any of the following symptoms:

• Cyanosis (bluish skin)
• Paleness
• Tachypnea or rapid breathing
• Anxiety

Asthma symptoms can interfere with daily activities, affect a person’s quality of life, and cause further complications.

Some complications of asthma may include:

• Tachycardia
• High blood pressure
• Frequent trips to the emergency room
• Respiratory distress or failure

Developing asthma nursing care plans

Although an incurable condition, asthma symptoms can be managed and controlled with routine changes and medication. When treating a patient with an asthma diagnosis, you can create a plan of care to minimize symptoms and reduce asthma attacks.

Asthma care plan for ineffective airway clearance

Signs and symptoms of ineffective airway clearance include:

• Wheezing
• Shortness of breath
• Productive cough
• Oxygen saturation of 85%
• Respiratory rate of 25

Some nursing interventions to improve air patency and clearance include:

• Vital sign and respiration assessment every four hours (or less)
• Suction phlegm secretions and sputum, as needed
• Provide supplemental oxygen
• Position the patient in an optimum position for effective breathing
• Administer prescribed medication (e.g., nebulizers, bronchodilators, steroids, and inhalers)

Asthma care plan for an ineffective breathing pattern

An ineffective breathing pattern is a critical condition and may cause respiratory failure if not detected and treated early. A number of diseases and conditions, including asthma, can affect a patient’s breathing pattern.

Evidence of an ineffective breathing pattern includes:

• Respiratory noise
• Nasal flaring
• Cyanosis
• Tachypnea
• Depth of breathing changes
• Coughing
• Shortness of breath

An asthma care plan for an ineffective breathing pattern includes many monitoring interventions to help stabilize the patient’s breathing pattern, including watching for:

• Signs of hypoxia
• Signs of distress
• Oxygen saturation
• Breathing abnormalities

Encourage rest and use calm, deep breathing when with the patient.

Asthma care plan for anxiety

Anxiety or a sense of panic can often accompany a patient with breathing difficulty and exacerbate asthma symptoms. A nursing asthma care plan for anxiety can help provide the patient with coping skills, minimize anxiety-related symptoms, and establish calmer conduct and behavior.

Some key interventions for treating anxiety (secondary to asthma) include:

• Observing for signs of panic
• Explaining procedures clearly
• Suggesting relaxation techniques, such as pursed lip breathing and positive affirmations
• Maintaining open lines of communication
• Providing assurances as needed

For asthma management, establish an oxygen saturation baseline and monitor for dips that may increase the risk of hypoxia.

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Although a common condition affecting adults and children, asthma can present a number of challenges for people. As a nurse working with asthmatic patients, understanding and recognizing asthma-related signs and symptoms can help improve patient outcomes.

Nursing students can access asthma exam prep material with SimpleNursing. Our educational YouTube channel can help you pass key nursing exams, such as the NCLEX, and have fun while studying.

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