Page 1046 - Saunders Comprehensive Review For NCLEX-RN

Radioallergosorbent Test: Blood test used to identify a specific allergen.
Chest Radiograph: May show hyperexpansion of the airways.

Note: Some tests place the child at risk for an asthma attack; testing should be
done under close supervision.

Table 35-2

Asthma Severity Classification System
Mild Intermittent symptoms less than once Inhaled *SABA or cromolyn before exercise or allergen exposure
intermittent per week No daily medications needed
Nighttime symptoms less than twice a
month
Asymptomatic and normal between
exacerbations
*FEV1 > 80% predicted, *PFT > 20%
variability
Mild Symptoms more than 2 times/week One daily controlled medication, low-dose inhaled corticosteroid;
persistent but less than once/day cromolyn/nedocromil, leukotriene modifiers
May affect activity and sleep Inhaled SABA as needed
Nighttime symptoms more than twice
a month
FEV1 > 80% predicted, PFT 20%-30%
variability
Moderate Daily symptoms, but not continual; Daily controller medications; combination inhaled medium-dose
persistent nighttime symptoms more than once a corticosteroid and LABA, especially for nighttime symptoms,
week, but not every night cromolyn/nedocromil, leukotriene modifiers
Affect activity and sleep Inhaled SABA as needed
Daily use of SABA
FEV1 60%-80% predicted, PFT > 30%
Severe Continuous daily symptoms Inhaled SABA as needed
persistent Frequent nighttime symptoms Multiple daily controller meds, high-dose inhaled corticosteroid,
Frequent exacerbations *LABA, cromolyn/nedocromil, leukotriene modifiers, may need
Physical activity limited by asthma long-term corticosteroids
FEV1 less than or equal to 60%
predicted, PFT variability > 30%
FEV1, Forced expiratory volume in 1 second; LABA, long-acting beta-adrenergic agonists; PFT, pulmonary
function tests; SABA, short-acting beta-adrenergic agonists.

Adapted from Dunphy LM, Winland-Brown JE, Porter BO, Thomas DJ: Primary care:
the art and science of advanced practice nursing, ed 4, Philadelphia, PA, 2015, FA Davis.

Box 35-4

Examples of Precipitants Triggering an Asthma
Attack

Allergens
Outdoor: Trees, shrubs, weeds, grasses, molds, pollen, air pollution,
sand dust, spores
Indoor: Dust, dust mites, mold, cockroach antigen
Irritants: Tobacco smoke, wood smoke, odors, sprays
Exposure to Occupational Irritants

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