In a severe acute exacerbation of asthma explain the pathogenesis that results in widespread

expiratory wheezes and dyspnoea.

Question 2.

Discuss two high priority nursing strategies used to manage a child with a severe acute exacerbation

of asthma and provide rationales for these strategies.

Question 3.

To manage a severe acute exacerbation of asthma in a child continuous nebulised salbutamol is

given. Three doses of ipratropium is added to the nebuliser at 20 minute intervals.

a) Discuss the mode of action of each of these drugs (salbutamol and ipratropium) relating to the
underlying pathogenesis.

b) Relating your answer to the pharmacology of the two drugs, discuss nursing implications
including how you will monitor and respond to adverse effects and how you will evaluate the

therapeutic effect.