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Albuterol is an example of a short-acting Beta-2 agonist. See Figures 5.11[1] and 5.12[2] for images of an albuterol inhaler and nebulizer. Salmeterol is an example of a long-acting Beta-2 agonist. See the “Autonomic Nervous System” chapter for more information regarding Beta-2 agonists. Figure 5.11 An albuterol inhaler Figure 5.12 A vial of albuterol sulfate for inhalationMechanism of Action Albuterol and salmeterol stimulate Beta 2-adrenergic receptors in the smooth muscle of bronchi and bronchioles producing bronchodilation. Beta-1 receptors can also be inadvertently stimulated, causing tachycardia. Indications for Use Short-acting albuterol is used to prevent or treat bronchospasms in people with asthma, reversible obstructive airway disease, or exercise-induced bronchospasm. Long-acting salmeterol is used to prevent bronchospasm. Adverse/Side Effects Beta-2 agonists can cause muscle tremor, excessive cardiac stimulation, and CNS stimulation.[3] Patient Teaching & Education Patients should be instructed to take medication as directed and report any sustained or worsening symptoms to their healthcare provider. When first using an inhaler, patients should be instructed to prime the inhaler unit prior to administering their medication. Use of medications like albuterol can cause an unusual taste in the mouth and rinsing the mouth with water after use is permitted. Patients should have an understanding of medication onset and use short-acting and long-acting inhalers appropriately.[4] Now let’s take a closer look at the medication grid for albuterol and salmeterol in Table 5.10.[5],[6],[7],[8],[9] Table 5.10 Albuterol and Salmeterol Medication Grid
Learn about the nursing care management of patients with asthma in this nursing study guide.
What is Asthma?Asthma affects people in their different stages in life, yet it can be avoided and treated.
PathophysiologyThe underlying pathophysiology in asthma is reversible and diffuse airway inflammation that leads to airway narrowing.
Statistics and EpidemiologyAsthma is considered the most common chronic disease of childhood and is a disruptive disease that affects school and work attendance.
CausesDespite increased knowledge on the pathology of asthma and the development of improved medications and management plans, the death rate from the disease continues to rise. Here are some of the factors that influence the development of asthma.
Clinical ManifestationsThe signs and symptoms of asthma can be easily identified, so once the following symptoms are observed, a visit to the physician is necessary.
PreventionPatients with recurrent asthma should undergo tests to identify the substances that precipitate the symptoms.
ComplicationsComplications for asthma include the following:
Assessment and Diagnostic FindingsTo determine the diagnosis of asthma, the clinician must determine that episodic symptoms of airway obstruction are present.
Medical ManagementImmediate intervention may be necessary, because continuing and progressive dyspnea leads to increased anxiety, aggravating the situation. Pharmacologic Therapy
Peak Flow MonitoringPeak Flow Meter. Image via: medlineplus.gov
Nursing ManagementThe immediate care of patients with asthma depends on the severity of the symptoms. Nursing AssessmentAssessment of a patient with asthma includes the following:
Nursing DiagnosisBased on the data gathered, the nursing diagnoses appropriate for the patient with asthma include:
Nursing Care Planning & GoalsMain Article: 5 Bronchial Asthma Nursing Care Plans To achieve success in the treatment of a patient with asthma, the following goals should be applied:
Nursing InterventionsThe nurse generally performs the following interventions:
EvaluationTo determine the effectiveness of the plan of care, evaluation must be performed. The following must be evaluated:
Discharge and Home Care GuidelinesA major challenge is to implement basic asthma management principles at the home and community level.
Documentation GuidelinesDocumentation is a necessary part of the nursing care provided, and the following data must be documented:
Practice Quiz: AsthmaLet’s reinforce what you’ve learned with this 5-item NCLEX practice quiz about Asthma. Please visit our nursing test bank for more NCLEX practice questions. 1. Histamine, a mediator that supports the inflammatory process in asthma, is secreted by: A. Eosinophils 2. Obstruction of the airway in the patient with asthma is caused by all of the following except: A. Thick mucus 3. A commonly prescribed mast cell stabilizer used for asthma is: A. Albuterol 4. There are several comorbid conditions that accompany asthma but it does not include: A. Gastroeasophageal reflux 5. The strongest predisposing factor for asthma is: A. Chronic exposure to airway irritants Answers and Rationale 1. Answer: C. Mast cells
2. Answer: C. Destruction of the alveolar wall
3. Answer: C. Cromolyn sodium
4. Answer: C. Hypertension
5. Answer: D. Allergy
See AlsoPosts related to Asthma:
[sc name=”Affiliate_MedicalSurgical”] When administering a betaFor example, albuterol is a short acting Beta-2 agonist that is given for bronchodilation. The nurse should plan to perform a respiratory assessment before and after administration of albuterol to document the effectiveness of the medication, as well as monitor for tachycardia, a common side effect.
How does an anti inflammatory drug reduce bronchoconstriction?They act by preventing leukotriene release from mast cells and eosinophils or by blocking the specific leukotriene receptors on bronchial tissues, thus preventing bronchoconstriction, mucus secretion, and oedema. These drugs also reduce the influx of eosinophils, thus limiting inflammatory damage in the airway.
Which drug is a long acting beta agonist inhaler?The long-acting beta(2)-agonists (LABAs), including salmeterol and formoterol, have 12-hour duration of action and are used with a twice-daily dosing regimen for long-term COPD treatment. Unlike salmeterol, formoterol has a rapid onset of action.
Which class of medication is the drug of choice for longInhaled corticosteroids (ICSs) are used in the long-term control of asthma.
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