Asthma

Nursing, May 2002 by Pope, Barbara B

PATIENTEDUCATIONSERIES

What is asthma?

Asthma is a disease that makes the airways in your lungs swell and get narrow. Mucus builds up inside the airways, so you have trouble getting air in and out of your lungs.

You can have an asthma attack when something "triggers" these problems in your lungs. During an attack, you may cough or wheeze (a whistling noise). Your chest may feel tight, and you may feel out of breath.

An asthma attack can be very serious. If you have trouble breathing, call 9-1-1 for help right away

You can't cure asthma, but you can control it. Here's what you should do every day.

Take your medicines

Take your asthma medicines the way your health care provider (nurse, physician, nurse practioner, or physician assistant) tells you (see How Does My Asthma Medicine Help Me?). Some medicines you may take come in an inhaler, which sends the medicine to your lungs.

You may have two types of inhalers. One type you use every day to prevent problems. Use the other type, called a "rescue" inhaler, only when you have an asthma attack. Make sure you know which is which and use them as told.

To use an inhaler, follow these steps:

1. Take off the cap and shake the inhaler.

2. Breathe out all the way.

3. Hold your inhaler as shown here. If your medicine is a steroid, keep it 1 to 2 inches from your mouth.

4. Press down on the inhaler one time and breathe in slowly through your mouth, as deeply as you can. (If you use a holding chamber, also called a spacer, wait 5 seconds after pressing on the inhaler, then breathe in slowly)

5. Hold your breath and slowly count to 10. Then breathe out.

6. Wait about 1 minute between puffs before using the inhaler again.

Use your peak flowmeter

A peak flowmeter helps you check how well your asthma is controlled from day to day. Measure your peak flow at the same time every day and when you feel an asthma attack coming on. Also use it before and after you take your rescue medicine and any other time your health care provider tells you to use it.

Follow these steps:

1. Move the marker to the bottom of the numbered scale.

2. Stand or sit up straight.

3. Take a deep breath. Fill your lungs all the way.

4. Hold your breath while you place the mouthpiece in your mouth, between your teeth. Close your lips around it. Don't bite down or put your tongue inside the hole.

5. Blow out as hard and fast as you can. Your peak flowmeter will measure how fast you can blow air out of your lungs.

6. Write down the number you get. If you cough or make a mistake, don't write down the number. Do it over again.

7. Repeat steps 1 through 6 two more times. Write down the highest of the three numbers. This is your peak flow number.

Take the numbers with you when you visit your health care provider. He will use these numbers to design a treatment plan for you.

Stay away from asthma "triggers"

Different things can trigger asthma attacks. Here's how to avoid some common asthma triggers.

* Stop smoking. If you smoke, stop. If you need help breaking the habit, ask your health care provider about using nicotine patches, medicine, hypnosis, or attending a class. If you live with someone who smokes, ask him to quit too. It's easier to quit if the people around you do too, and you won't be breathing secondhand smoke.

* Keep your house clean. Put a special dustproof cover on your mattress and pillow. Change your bedsheets every week and wash them in hot water. Ask someone else to dust or vacuum. If you must clean, wear a mask and vacuum with a HEPA-filter vacuum. Also, install a HEPA filter in your bedroom.

* Stay away from strong odors and sprays, such as perfume and paint. Breathing these odors may trigger an attack.

* Don't have furred or feathered pets in your home, if possible. If you have pets, keep them out of your bedroom and out of rooms with carpets and cloth furniture. Wash your pets every 2 weeks with water and a mild antiallergy pet shampoo.

* Cover your nose and mouth with a scarf on cold or windy days. This warms up the air you breathe before it reaches your lungs.

* Avoid pollen and mold. Clean moldy surfaces with a cleaner that can kill mold and mildew. Keep your windows closed when there's a lot of pollen in the air or it's windy. Use an air conditioner when it's hot outside. Try to stay indoors in the afternoon when pollen counts are highest.

Visit your health care provider frequently

When you go, take a list of questions with you. Bring your peak flowmeter and inhalers too.

Adapted firm Facts about Controlling Asthma, National Asthma Education and Prevention Program, National Heart, Lung, and Blood Institute, NIH Publication No. 97-2339.

This patient-education guide has been adapted for the 5th-grade level using the Flesch-Kincaid and SMOG formulas. It may be photocopied for clinical use or adapted to meet your facility's requirements. Selected references are available upon request. For more tips on writing education guides, see the first article in this series: "Writing Easy-to-Read Teaching Aids" (March 2002).