Pediatric Asthma (Nursing)

Etiology and Pathophysiology

Asthma is a chronic inflammatory airway disease characterized by recurrent airflow obstruction due to bronchospasm, edema, and mucus production. The etiology is multifactorial, involving a complex interplay between genetic predisposition and environmental triggers.

Assessment and Diagnosis

Clinical presentation includes wheezing, cough, chest tightness, and shortness of breath. Diagnosis is supported by physical examination for allergic or airway-related signs and confirmed in children over five using pre- and post-bronchodilator spirometry, which measures improvement in FEV1.

Medical Management (Step Therapy)

Management follows a step-therapy approach (EPR-3 guidelines). Step 1 utilizes short-acting beta-agonists (SABA) for rescue. Steps 2 through 6 focus on long-term control using inhaled corticosteroids (ICS), often in combination with long-acting beta-agonists (LABA) or leukotriene receptor antagonists, with specific adjustments made based on age and severity.

Nursing Management of Acute Exacerbations

Nursing care focuses on stabilizing acute exacerbations using nebulized albuterol, supplemental oxygen (targeting SpO2 90-92%), and systemic corticosteroids (oral or IV). Nursing diagnoses include ineffective breathing patterns and airway clearance. Comprehensive discharge planning, including an individualized asthma action plan, is essential for prevention.