Pediatric Asthma (Nursing)

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.

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.

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 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.