Asthma is a common condition, as you know from watching your BFF use her inhaler when she starts to wheeze. It’s also a condition where self-management makes a big difference, which means patients need lots of education, coaching and support. Enter the nurse, who is often the healthcare professional doing all that teaching, coaching and supporting.
People who have asthma need to understand the disease, including what causes it, what the symptoms are and what things might come along with it, such as eczema and allergies. The goal of asthma management is to prevent acute episodes. If allergies make asthma worse, for example, the patient must know what to do to avoid potential allergens and how to modify his normal asthma management routine. The nurse is in the best position to perform all this teaching, according to the National Institutes of Health document, “Nurses: Partners in Asthma Care.”
Exacerbation of Asthma
Asthma is a disease which occasionally becomes worse, a condition known as an exacerbation. In some cases, the exacerbation might be serious enough to require emergency treatment or even hospitalization. When a patient has an asthma exacerbation, the nurse’s role is to help treat and manage the flare-up while preventing complications. This could include more intensive therapies such as inhaled medications and breathing treatments, or in extremely serious cases, the use of a ventilator to help the patient breathe. During hospitalization, the nurse provides direct care and coordinates care provided by other healthcare professionals such as respiratory therapists.
Advanced practice nurses often have the responsibility for overall management of a patient’s asthma. Nurse practitioners are masters-prepared registered nurses who perform most of a physician’s functions. Most NPs specialize in family practice or pediatrics, and often provide asthma care as part of their primary care responsibilities. When an NP is managing an asthma patient’s care, she examines the patient, orders diagnostic testing such as pulmonary function or arterial blood gas tests, selects and prescribes the specific medication a patient needs, and makes referrals to specialists such as pulmonologists when necessary.
Surgery and GERD
Surgery can increase the risk of asthma exacerbation, especially when it is performed with general anesthesia. In addition, many asthmatics also suffer from gastroesophageal reflux disease, or GERD -- a fancy name for a condition that causes heartburn. When a patient has both asthma and GERD, her asthma symptoms often get worse. Raising the head of the bed helps GERD, but may not be possible during or after surgery. The nurse must be alert for symptoms of an asthma exacerbation and take steps to prevent complications.
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