Here are the nursing assessment and interventions for this asthma nursing care plan.
| Nursing Interventions | Rationale |
|---|---|
| Nursing Assessment | |
| Assess the client’s knowledge of care for status asthmaticus, as appropriate. | Knowledge of how to handle care can save time. |
| Assess past and present therapies, including the client’s response to them. | Knowledge of what has been effective in the past determines the appropriate intervention needed. |
Assess the client’s knowledge of asthma triggers and asthma medications:
| Identifying the asthma triggers will make the client know how to control them; Correct use of spacers by slow, deep inhalation and breath-holding after inhalation will ensure the effectiveness of the medication. Improper use of an MDI will lead in the medications not getting deep enough to affect the airway. |
| Assess the client’s tobacco use. | Assessment of tobacco use is important for clients suffering from lung disease. If the client is a tobacco user, cessation of smoking should be stressed. |
| Therapeutic Interventions | |
| Evaluate self-care activities: preventive care and home management of an acute attack. | Since it is a chronic disease, the client must be able to self-manage the disease. |
| Explain the disease to the client and significant others. | A misconception regarding asthma attack is that it can be managed without medication through self-control and discipline. Knowledge on asthma self-management reduces the need for frequent hospitalizations. |
Instruct the client how to avoid asthma triggers:
| Environmental trigger control can lessen the frequency of asthma attacks and improve the client’s quality of life. |
| Educate the client about the warning signs and symptoms of an asthma attack and the importance of early treatment of an impending attack. Provide a written copy of daily exacerbation management. | A written treatment plan is needed by the client to reinforce information that was already taught. Early treatment within 6 hours of an attack may lessen the chance of hospitalization. |
| Review all medications with the client including a discussion of short versus long-acting medications, a review of zones, and the dosage of each medication in each zone. | Short-acting beta-agonists are the first line medication of choice since they relieve acute asthma attacks very quickly compared to the long-acting. Beta-2-adrenergic agonist should be used before inhaled steroids since they open the airways and allow the anti-inflammatory medication to reach deeper into the lung fields. Rinsing the mouth after using an inhaled steroids prevents yeast infection. Anti-inflammatory medications, such as inhaled steroids, work by reducing swelling and mucus production in the airways. As a result, the airways are less sensitive and less likely to respond to asthma triggers and cause asthma symptoms. |
| Reinforce the need for taking controller medications as indicated. | Asthma is a chronic condition that is present even when attacks are not occurring. Medications such as bronchodilators and anti-inflammatory agents reduce the incidence of attacks. |
| Teach how to administer nebulizer treatments, Diskus, MDIs spacers, or dry powder capsules with the correct technique. | Providing return demonstrations on techniques are needed to ensure appropriate delivery of the medication. |
| Instruct in the use of peak flow meters and develop an individualized plan on how to adjust medications and when to seek medical advice. Establish the client’s personal best peak expiratory flow rate (PEFR). | Use the zone system individualized to the client. Personal best is established by having the client take and document peak flow each morning before medication use and in the late afternoon for 2 weeks. Personal best is the highest peak flow reading regularly blown, which is then used to calculate the client’s zone.
|
| Discuss the importance of pneumococcal pneumonia vaccine and influenza vaccine yearly. | Regular immunizations reduce the chance of acquiring these diseases. |
| Reinforce what to do in an asthma attack (Home management and prevention, and when to seek urgent hospitalization). | Information enables the client to take control and reduce life-threatening complications. Hospitalization is required for severe exacerbations, the severity of the condition and poor response to treatment. |
| Address long-term management issues. | Control of allergens, avoidance of precipitators, environmental control, avoidance of air pollutants such as perfumes, aerosol sprays, powder, and health habits prevents the occurrence of asthma attacks. |
| Discuss the use of a medical alert bracelet or other identification. | These identification alert others to an asthma history to facilitate the delivery of safe, effective medical care. |
| Instruct the client to keep emergency phone numbers readily available. | These will help in seeking immediate medical attention. |
| Refer to support groups, as appropriate. | Asthma support groups offer an environment in which the client can learn new ways of dealing with the illness and appropriate health behavior changes such as smoking cessation. |
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