Asthma is a common medical condition in which the airways swell, produce copious amounts of mucus, and become narrow. These events can trigger wheezing, coughing and make it difficult for a person to breathe.
Although some people only experience mild symptoms of asthma, others may have significant problems with their breathing, which may interfere with their daily activities. A few patients also experience life-threatening asthmatic attacks, which need immediate medical attention.
There is no cure for asthma, but your symptoms can be treated. For nurses, making a nursing diagnosis for asthma can help them recognize a patient's needs and plan for their care.
What Is Nursing Diagnosis?
Nursing diagnosis is based on a nurse's clinical judgment about a patient's actual or potential problems or life processes related to the disease. It provides the nurse a basis for selecting nursing interventions to improve patient outcome, for which he/she has accountability. This is different from a medical diagnosis, based on a doctor's evaluation of a patient's pathological condition, which may need pharmacological/non-pharmacological treatments.
7 Nursing Diagnosis for Asthma
1. Ineffective Airway Clearance
Ineffective airway clearance related to asthma results from the body's overproduction of antibodies and release of chemicals, which trigger tightening of the airways (bronchospasm), a major characteristic of asthma. This is often coupled with mucus buildup, which plugs the airways, causing ineffective clearance of the airways.
Symptoms
- Anxiety
- Changes in the rate and depth of respiration
- Chest tightness
- Coughing
- Cyanosis
- Difficulty breathing
- Loss of consciousness
- Persistent cough with/without sputum
- Rapid breathing
- Rapid pulses
- Restlessness
- Use of accessory muscles in the chest
- Wheezing
Interventions
- Administer medications and nebulization as ordered.
- Assist the patient in expelling mucus (postural drainage).
- Encourage the patient to use diaphragmatic breathing and practice coughing exercises.
- Ensure adequate hydration.
- Teach patient to recognize early signs of infection to be reported to their health care provider.
- Teach the patient to avoid respiratory irritants like aerosols, cigarette smoke, fumes, andextremes of temperature.
2. Ineffective Breathing Pattern
This nursing diagnosis for asthma is due to the presence of mucus in the airways (bronchi), which results in blockage of air to the lungs and the body. Inability to keep the airways clear due to bronchospasm is caused by stimulation of the receptors and chemical mediators, which are released in the presence of irritants or allergens.
Symptoms
- Anxiety
- Chest tightness
- Coughing
- Cyanosis
- Difficulty breathing
- Loss of consciousness
- Rapid breathing
- Rapid pulses
- Restlessness
- Wheezing
Interventions
- Assess the patient's respiration with regards to depth, rate, and rhythm.
- Auscultate the patient's breath sounds and assess his breathing pattern.
- Elevate the head of the bed and change the patient's position every two hours.
- Encourage the patient to limit physical activities and to rest.
- Ensure adequate hydration.
- Encourage the patient to do deep breathing and practice coughing exercises.
- Monitor the patient's vital signs.
- Reinforce a diet that is low in salt and low in fat.
- Teach the patient to do diaphragmatic breathing and pursed-lip breathing.
- Use pulse oximetry.
3. Impaired Gas Exchange
Thisnursing diagnosis for asthma relates to the decreased amount of air that is exchanged during inspiration and expiration. Ventilation is impaired in spite of adequate perfusion in the lungs.
Symptoms
- Altered consciousness
- Anxiety
- Changes in arterial blood gases (ABGs)
- Chest Tightness
- Coughing, with yellow sticky sputum
- Cyanosis
- Dyspnea
- Rapid breathing
- Rapid pulses
- Restlessness
- Wheezing
Interventions
- Assess the patient's respiration with regards to depth, rate, and rhythm.
- Auscultate the patient's breath sounds and assess his breathing pattern.
- Elevate the head of the bed and change the patient's position every two hours.
- Encourage the patient to limit physical activities and to rest.
- Ensure adequate hydration.
- Encourage the patient to do deep breathing and practice coughing exercises.
- Monitor the patient's vital signs.
- Reinforce a diet that is low in salt and low in fat.
- Teach the patient to do diaphragmatic breathing and pursed-lip breathing.
4. Fatigue
This nursing diagnosis for asthma relates tofluid accumulation in the lungs, which reduces their ability to expand and makes breathing difficult. The patient uses his accessory muscles to support breathing, but this results in a feeling of tiredness and fatigue.
Symptoms
- Decreased performance
- Generalized weakness
- Inability to do usual routines
- Lethargy
- Reduced concentration
- Tiredness
- Verbal expression of extreme lack of energy
Interventions
- Alternate activities with rest periods.
- Assist patient to identify coping behaviors.
- Avoid unpleasant topics that may upset the patient.
- Discuss the patient's need for activity. Create a schedule with the patient and identify the activities that may lead to fatigue.
- Encourage the patient to limit physical activities and to rest.
- Establish rapport.
- Increase the patient's participation in activities of daily living (ADL) as tolerated.
- Monitor the patient's vital signs before and after activities.
- Monitor the patient's vital signs.
- Provide an environment that helps to relieve fatigue.
5. Activity Intolerance
This nursing diagnosis for asthma relates to inadequate oxygen in the body, which can lead to weakness in the muscles. The patient is not able to tolerate activities due to low oxygenation resulting from inadequate lung expansion.
Interventions
- Assess the patient's motor function.
- Assist the patient in performing self-care.
- Elevate the patient's arms and hands.
- Evaluate the patient's ability to stand and move around.
- Evaluate the patient's degree of deficit.
- Gradually increase activities and exercise; assist the patient in doing passive to active and full range of motions.
- Monitor the patient's vital signs before and after activities.
- Observe factors that may contribute to fatigue.
- Place the patient's knees and hips in an extended position.
- Plan nursing care with rest periods between activities.
- Provide adequate periods for rest.
6. Anxiety
This nursing diagnosis for asthma relates tothe patient's perception of a crisis situation, change in health status, and threat to life.
Symptoms
- Apprehension
- Fearful expression
- Extraneous movements
Interventions
- Create a relaxed mood and use a relaxed facial expression.
- Encourage patient to relax and control respiration by drawing deep breaths.
- Encourage the patient to assume a relaxed position.
- Explain care procedures to the patient.
- Instruct the family to act as a support system for the patient during an asthma attack.
- Listen to the patient.
7. Imbalanced Nutrition
This nursing diagnosis for asthma relates to a patient's having less than body requirements due to shortness of breath and activity intolerance.
Symptoms
- Inability to eat related to respiratory distress
- Anorexia leading to weight loss
Interventions
- Collaborate with the nutritionist for the patient's favorite meals.
- Encourage patient to eat frequent, small meals.
- Evaluate the patient's food preferences and diet recommendation.
- Limit visitations during mealtimes.
- Monitor patient's oral intake and add parenteral nutrition if insufficient.
- Provide a relaxed atmosphere for dining.