llbgurl's version from 2015-10-06 16:06


Question Answer
chronic airway inflammation with superimposed bronchospasmsasthma
most common chronic illness in children and leading cause of hospitalization/school absenteeismasthma
50% present by 2 yrs 80% present by 5 yearsasthma
wheezing predominant signbronchospastic asthma
cough variantcough predominant sign
inflammatorychronic bronchitis predominanat sign
precipitating factors to asthmaviral respiratory illness, 2500 g birth weight, NSAID, ASPIRIN, Beta Blockers, temperature changes
late sign of asthmapallor/cyanosis
barrel shaped and increased a/p diameter of chestasthma
prolonged expiration, expiratory wheeze, tachypnea with tachycardiamild asthma
acessory muscle use, inspiratory and expiratory wheezemoderate asthma
cyanosis, decreased aeration, anxiety, sweating, lethargysevere asthma
pulse ox below 90%, condition worsens after treatmentarterial blood gas
normal PC02 in asthmaindicates WORSENING status of asthma
low PC02 in asthmaearly s/s of early asthma
wheezing for the first time r/o:congeintal/pulonary vasculature malformation or FB
hyperinflation, peribrnchial thickening, areas of densities, subsegmental atelectasisasthma
measures degree of obstruction and response to adminsitered bronchiodilators in children OVER 5pulmonary function tests
helpful for baselinespirometry peak flow
can be used for worsening bronchospasmsspirometry
FEV1, FVC, PEFRspirometry/peak flow
not diagnosed with first wheezing attack, document pattern of recurrent wheezing and response to treatmentasthma
02 sat 95 and above, solumedrol 1-2 mg/kg IV q6 hrs start earlyasthma
less than 2 times a month day and night sx, saba used less than 2 times a weekintermittent asthma
day sx above 2 times a week, above 2 HS wakenings month, saba used 2 times a week or more NOT dailymild persistant asthma
daily day sx, at least once a week HS, some limitation with activitymoderate peristant asthma
frequent day/night sx, exterme limited activitysevere persistant asthma
relax smooth muscle releaves bronchospasmsbeta adrenergics
proventil, ventolin (albuterol) and levalbuterolshort acting 4-6 hours
has ability to provide greater bronchodilation with a lower doseXopenex (levalbuterol)
salmetrol (serevent)long acting 12 hours not for relief sx
serevent powder discus long acting for ages 4 and older
adjunctive therapytheophylline oral or IV
must check serum levels 5-15 = theraputic has toxic s/etheophylline
stabilzes mast cells, prevents histamine relief and bronchial hyper responsivenesscromolyn sodium
short acting cromolyn sodium Intal
long acting cromolyn sodium Nedocromil
used for prophylaxsis and has to be used TID for optimal resultscromolyn sodium
exercise induced asthma can helpcromolyn sodium
1-2 mg/kg/day for 5-7 daysprednisone burst
beclomethasone, triamcinolone, flunisolide, fluticasone, budesonideall inhaled steriods safe and non-toxic
fluticasone (flovent)must wash mouth after use, ages 4 and older
busesonide (pulmicort)only once a day inhaler, 6 and older, no taste or smell
singularcan start at 2 years of age can be continued during an attack
>80% peak flowchilds baseline and normal
50-80% peak flowobstruction
below 50% peak flowacute asthma attack
after MDI use to prevent monoilial infectionmust wash mouth out

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