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exacerbation, may indicate impending respiratory failure due to diffuse
bronchospasm, and is a life-threatening condition.
6. Refer to Chapter 35 for additional information on
asthma.
B. Assessment
1. Restlessness
2. Wheezing or crackles
3. Absent or diminished lung sounds
4. Hyperresonance
5. Use of accessory muscles for breathing
6. Tachypnea with hyperventilation
7. Prolonged exhalation
8. Tachycardia
9. Pulsus paradoxus
10. Diaphoresis
11. Cyanosis
12. Decreased oxygen saturation
13. Pulmonary function test results that demonstrate
decreased airflow rates
C. Interventions
1. Monitor vital signs.
2. Monitor pulse oximetry.
3. Monitor peak flow.

4. During an acute asthma episode, provide

interventions to assist with breathing (Box 50-6).
D. Client education

1. On the intermittent nature of symptoms and need for
long-term management
2. To identify possible triggers and measures to prevent
episodes
3. About the management of medication and proper
administration
4. About the correct use of a peak flowmeter
5. About developing an asthma action plan with the
PHCP and what to do if an asthma episode occurs

VIII. Chronic Obstructive Pulmonary Disease

A. Description
1. Also known as chronic obstructive lung disease and
chronic airflow limitation
2. Chronic obstructive pulmonary disease is a disease
state characterized by airflow obstruction.
3. Chronic bronchitis and emphysema are progressive
lung diseases that fall under the general category of
chronic obstructive pulmonary disease.
4. Chronic bronchitis is a condition in which the

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