Asthma

Asthma is a chronic respiratory disease characterized by variable symptoms and variable expiratory airflow limitation, usually with chronic airway inflammation. During symptoms, bronchoconstriction, thickening of the airway wall, and increased mucus narrow the airways. Symptoms can be severe even when they are infrequent, and a normal examination between episodes does not exclude asthma. Typical symptoms are wheeze, shortness of breath, chest tightness, and cough. They often vary over time, worsen at night or on waking, and follow exercise, viral respiratory infection, allergens, cold air, smoke, vaping, or workplace exposure. Some medicines, including beta-blockers and, in susceptible patients, ASA or other nonsteroidal anti-inflammatory drugs, can provoke symptoms. The nursing mental model is to assess two things together: the patient's current respiratory status and the risk of a future severe exacerbation. Previous severe attacks, poor adherence to inhaled corticosteroid treatment, incorrect inhaler technique, smoke exposure, low lung function, and comorbid illness can increase risk even when today's symptoms are limited. Diagnosis requires a compatible history plus documented variable expiratory airflow; the RN gathers and trends evidence but does not independently diagnose asthma...