In this guide are eight (8) NANDA nursing diagnosis for asthma nursing care plans including their nursing assessment and interventions. The client has acidosis, hypoxemia, hypoxia, and hypercapnia; all of these together with effects of … Interventions: Administration of inhalational anesthetics. Status asthmaticus is always treated as a medical emergency. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. The following nursing diagnoses are applicable to patients with Status Asthmaticus: Main Article: 5 Bronchial Asthma Nursing Care Plans. Ensure patient’s room is quiet and free of respiratory irritants (eg, flowers, tobacco smoke, perfumes, or odors of cleaning agents); nonallergenic pillows should be used. However, most people make a full recovery after being … No correlation between severity of attack and number of wheezes; with greater obstruction, wheezing may disappear, possibly signaling impending respiratory failure. Provide information about disease process, prognosis, and treatment regimen. Assess the client’s vital signs as needed while in distress. Allergens, air pollutants, cold weather, physical exertion, strong odors, and medications are common predisposing factors for asthma. Eight Edition. ized for status asthmaticus at a university hospital. Sex and age distribution ofdeaths. Corticosteroids (such as prednisone) given by mouth or intravenously (into a vein) 4. Assist with measures to facilitate gas exchange. Pellico, L. H., Bautista, C., & Esposito, C. (2012). 281-287. The critical care practitioner must understand the chronic as well as the acute nature of the condition in order to provide effective intervention. I really like coming here for my class. The main focus of nursing management is to actively assess the airway and the patient’s response to treatment. Therapeutic Communication Techniques Quiz. … He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. Blood pressure and cardiac rhythm should be monitored continuously during the acute phase and until the patient stabilizes and responds to therapy. A retrospective review of consecutive admissions for status asthmaticus covering a 13-month period yielded 130 charts for review. Status asthmaticus is severe and persistent asthma that does not respond to usual therapy; attacks can occur with little or no warning and can progress rapidly to asphyxiation. Ackley, B. J., Ladwig, G. B., Msn, R. N., Makic, M. B. F., Martinez-Kratz, M., & Zanotti, M. (2019). Werner HA. Adventitious sounds may indicate a worsening condition or additional developing complications such as. Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Patients: From 1992 to 1998, we documented clinical data, gas exchange and outcome of every asthmatic patient admitted to our ICU because of status asthmaticus (SA) refractory to initial medical therapy. Therapeutic Communication Techniques Quiz. The nurse should be prepared for the next intervention if the patient does not respond to treatment. An ominous finding is a respiratory acidosis, which usually indicates that respiratory failure is pending and that. Hospitalization if no response to repeated treatments or if blood gas levels deteriorate or pulmonary function scores are low. This article will explain how status When an individual is exposed to a trigger, an immediate inflammatory response with bronchospasm happens. Clinical interventions for spontaneously breathing children with status asthmaticus should be based primarily upon physical examination findings and not blood gas determinations. Nurseslabs.com is an education and nursing lifestyle website geared towards helping student nurses and registered nurses with knowledge for the progression and empowerment of their nursing careers. ... A 10-year-old presents in status asthmaticus complaining of chest tightness and has audible wheezing. The following are the references and sources for the nursing diagnosis and nursing care plan for asthma: You may also like the following posts and care plans: Care plans about respiratory system disorders: I now know how to tackle nursing care plans. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Nurseslabs.com is an education and nursing lifestyle website geared towards helping student nurses and registered nurses with knowledge for the progression and empowerment of their nursing careers. Assess the presence of paradoxical pulse of 12 mm Hg or greater. Corticosteroids reduce inflammation in the airways that carry air to the lungs and reduce the mucus made by the bronchial tubes. Status asthmaticus can vary from a mild form to a severe form with bronchospasm, airway inflammation, and mucus plugging that can cause difficulty breathing, carbon dioxide retention, hypoxemia, and respiratory failure. Background: Status asthmaticus is an acute exacerbation of asthma that is persistent and intractable and remains unresponsive to initial treatment with bronchodilators and systemic corticosteroids and that the condition can result in hypoxemia, hypercarbia, and secondary respiratory failure. Here are the nursing assessment and interventions for this asthma nursing care plan. We found that practice patterns with respect to documentation of severity of illness, medications, and,Nthma is a major worldwide health care problem Oxygen saturation is a term referring to the fraction of oxygen-saturated hemoglobin relative to the total hemoglobin in the blood. This is so easy.one can just come here and retrieve whatever nursing diagnosis is needed.thanks for making the work easy. Effects of nursing instruction on asthma knowledge and quality of life in schoolchildren with asthma. Doctors also call it acute severe asthma. Yang, B. H., Chen, Y. C., Chiang, B. L., & Chang, Y. C. (2005). Unfortunately, some people with status asthmaticus may not recognize the severity of their symptoms, and their breathing abilities may rapidly decline. Status asthmaticus is a condition in which severe airway obstruction and asthmatic symptoms persist despite the administration of standard acute asthma therapy.6 It … This condition is a medical emergency that can cause death without treatment. show the sameappearance as those dying in status asthmaticus (Walton, Penner & Wilt, 1951; and personal observation), and serves to illustrate the fallibility of clinical assessment in certain cases of status asthmaticus. Constantly monitor the patient for the first 12 to 24 hours, or until status asthmaticus is under control. NURSING ALERTIn status asthmaticus, the return to normal orincreasing partial pressure of carbon dioxidedoes not necessarily mean that the patientwith asthma is improving—it may indicate afatigue state that develops just before thepatient slips into respiratory failure. Acute severe asthma, also known as status asthmaticus, is an acute exacerbation of asthma that does not respond to standard treatments of bronchodilators (inhalers) and corticosteroids. Here are eight (8) nursing care plans and nursing diagnosis for asthma: The following are the common related factors for the nursing diagnosis Ineffective Breathing Pattern. Measurements and Main Results: Primary outcome was … We examined physician management of patients hospitalized for status asthmaticus at a university hospital. Setting: Intensive care unit of a tertiary care hospital. Changes in the respiratory rate and rhythm may indicate an early sign of impending respiratory distress. Encourage the patient to conserve energy. Patients: Two patients with severe status asthmaticus. Allergens, air pollutants, cold weather, physical exertion, strong odors, and medications are common predisposing factors for asthma. When done with good effort, it correlates well with forced expiratory volume in 1 second (FEV, During a mild to moderate asthma attack, clients may develop respiratory alkalosis. © 2021 Nurseslabs | Ut in Omnibus Glorificetur Deus! Fatigue may indicate distress, leading to respiratory failure. Hi, I'm a pre-nursing student awaiting application results. Administer aminophylline IV per provider order ; Monitor the client's respiratory status for signs of hypoxia Interventions: Standardized treatment per National Heart, Lung, and Blood Institute guidelines. Infection, anxiety, nebulizer abuse, dehydration, increased adrenergic blockage, and nonspecific irritants may contribute to these episodes. The nurse is caring for a client in status asthmaticus. Pursed lip breathing improves breathing patterns by moving old air out of the lungs and allowing for new air to enter the lungs. Finding help online is nearly impossible. Our ultimate goal is to help address the nursing shortage by inspiring aspiring nurses that a career in nursing is an excellent choice, guiding students to become RNs, and for the working nurse – helping them achieve success in their careers! Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Measurements and Main Results: Both patients had respiratory failure secondary to status asthmaticus requiring mechanical ventilation and permissive hypercapnia. A Davis Compan Asthma continued3 Complication Status asthmaticus Severe from NURSING 101 at Community College of Philadelphia When an individual is exposed to a trigger, an immediate inflammatory re… ars old with a known diagnosis of asthma presenting with status asthmaticus. interventions. 2. Status asthmaticus is a serious condition that requires ongoing management. Magnesium sulfate delivered int… Learn more about the goals, related factors and rationale for each nursing interventions for asthma. Assess the patient’s skin turgor for signs of dehydration; fluid intake is essential to combat dehydration, to loosen secretions, and to facilitate expectoration. This group was compared with a prepathway group of 141. Mannix R, Bachur R. Status Asthmaticus in Children. Short-acting beta-agonists (such as albuterol) via inhaler or nebulizer 3. The nurse should be prepared for the next intervention if the patient does not respond to treatment. The overriding physiologic derangement in asthma is airway inflammation, and corticosteroids are a mainstay in the management of both acute and chronic asthma. Status asthmaticus can vary from a mild form to a severe form with bronchospasm, airway inflammation, and mucus plugging that can cause difficulty breathing, carbon dioxide retention, hypoxemia, and respiratory failure. Standard treatment protocols in the emergency room include: 1. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. Asthma treatment (asthma attack), symptoms, pathophysiology nursing NCLEX review lecture. Once the movement of air into and out of the lungs becomes challenging, the breathing pattern changes. It is measured in liters per second and requires maximal effort. Hence, ventilation of the patient is the key intervention to relieve oxygen deprivation. The peak expiratory flow rate is the maximum flow rate that can be generated during a forced expiratory maneuver with fully inflated lungs. Reactive airways allow air to move into the lungs more easily than out of the lungs. Volume 1. And when it becomes severe, BP and HR drops and respiratory failure may result. They relax the muscles lining the airways that carry air to the lungs; treatment of choice for acute exacerbation of asthma. Asthma is caused by multiple genes, some having protective effect, with each gene having its own tendency to be influenced by the environment although a genetic link leading to acute severe … 1,3 Prednisone, methylprednisolone, prednisolone, hydrocortisone, and dexamethasone are commonly prescribed and should be administered for 3 to 10 days. When a person has asthma, their doctor typically prescribes an inhaler that contains long-acting medications to keep the airways open. Status asthmaticus is an acute exacerbation of asthma that remains unresponsive to initial treatment with bronchodilators. Which of the following is a priority nursing action?. Prevent complications and slow progression of condition. Mechanical ventilation can be done through noninvasive and invasive procedures. Asthma is the most common chronic disease of childhood. Curr Opin Pediatr. Activity increases metabolic rate and oxygen requirements. Asthma is a chronic inflammatory lung disease that causes airway hyperresponsiveness, mucus production, and mucosal edema resulting in reversible airflow obstruction. Primarily pulmonary function studies and ABG analysis, Respiratory alkalosis most common finding. Nurseslabs – NCLEX Practice Questions, Nursing Study Guides, and Care Plans, Health-Seeking Behaviors: Prevention of Asthma Attack, Nursing Care Plan: The Ultimate Guide and Database, Nursing Test Bank and Nursing Practice Questions for Free, NCLEX Practice Questions Test Bank (2021 Update), Nursing Pharmacology Practice Questions & Test Bank for NCLEX (500+ Questions), Arterial Blood Gas Analysis Made Easy with Tic-Tac-Toe Method, Select All That Apply NCLEX Practice Questions and Tips (100 Items), IV Flow Rate Calculation NCLEX Reviewer & Practice Questions (60 Items), EKG Interpretation & Heart Arrhythmias Cheat Sheet. Hypoxemia leads to increased respiratory rate and depth, and carbon dioxide is blown off. Inhaled steroids should be given after beta-2-adrenergic agonist. Nurse Salary 2020: How Much Do Registered Nurses Make? Highflow supplemental oxygen is best delivered using a partial or complete nonrebreather mask (PaO2 at a minimum of 92 mm Hg or O2 saturation greater than 95%). Increased BP, RR, and HR occur during the initial hypoxia and hypercapnia. How do i save for offline reading. Nurseslabs – NCLEX Practice Questions, Nursing Study Guides, and Care Plans, Nursing Test Bank and Nursing Practice Questions for Free, NCLEX Practice Questions Test Bank (2021 Update), Nursing Pharmacology Practice Questions & Test Bank for NCLEX (500+ Questions), Arterial Blood Gas Analysis Made Easy with Tic-Tac-Toe Method, Select All That Apply NCLEX Practice Questions and Tips (100 Items), IV Flow Rate Calculation NCLEX Reviewer & Practice Questions (60 Items), EKG Interpretation & Heart Arrhythmias Cheat Sheet. Administer IV fluids as prescribed, up to 3 to 4 L/day, unless contraindicated. [box type=”warning”]NURSING ALERT: Rising PaCO2 to normal or higher is a danger sign, signaling respiratory failure.[/box]. Clinical management for positive outcome. The nursing interventions for the nursing diagnoses ineffective breathing pattern include assessing the patient’s vital signs (blood pressure, heart rate, and respiration rate), auscultation of breath sounds (wheezing, respiration depth and rhythm), monitor for the presence of pulsus paradoxes that is greater than or equal to 12 mmHg as this could be a sign of severe … Patients admitted to the PICU for status asthmaticus infrequently require critical interventions if they have not been initiated in the ED. Systemic corticosteroids are an integral part of the first-line medication for moderate-to-severe asthma attacks. List three (3) nursing interventions necessary to manage renal calculi in this client's care.-The nurse must strain the urine, manage pan, and increase their daily fluid intake. Status Asthmaticus places the client at high risk for respiratory failure. Status asthmaticus, although a relatively infrequent cause of admission to the intensive care unit, carries a significant risk of mortality and complications of critical care.1 Asthma prevalence has risen,2 and recent data have suggested an improvement in overall mortality.3 Yet there may remain a subgroup of patients with the most severe asthma in whom this outcome benefit may … Asthma is a chronic inflammatory lung disease that causes airway hyperresponsiveness, mucus production, and mucosal edema resulting in reversible airflow obstruction. ... [Show full abstract] standard of care in the treatment of status asthmaticus. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively. Overview Inflammatory disorder of airways Stimulated by triggers (infection, allergens, exercise, irritants) Status Asthmaticus – life-threatening condition Asthma unresponsive to treatment Nursing Points General Narrowed airways = ↓ gas exchange Inflammation of airways Bronchoconstriction Excessive mucus production Assessment … Objective. This article reviews the epidemiology and pathophysiology of asthma, clinical assessment, management principles, therapeutic modalities, and future approaches to the management of asthma. Paradoxical pulse is an abnormally large decrease in systolic. Nurse Salary 2020: How Much Do Registered Nurses Make? Encourage client to use pursed-lip breathing for exhalation. Ineffective Airway Clearance related to bronchospasms and increased pulmonary secretions. Intervention: One-hundred five admissions to a PICU for status asthmaticus were treated according to a new de-escalation pathway between August 15, 2015, and August 30, 2016. In patients with status asthmaticus, the main goal of intervention is to provide adequate oxygenation and prevent air trapping while doing this. Dyspnea during a normal conversation is a sign of respiratory distress. June 2007; Vol 19(3), pp. Magnesium sulfate has bronchodilating and anti-inflammatory effects that are sometimes used in the treatment of moderate to severe asthma in children. Airway management; Anxiety reduction; Oxygen therapy; Airway suctioning;Airway insertion and stabilization; Cough enhancement; Mechanical ventilation; Positioning;Respiratory monitoring Two predominant pathologic problems occur: a decrease in bronchial diameter and a ventilation–perfusion abnormality. This promotes maximum lung expansion and assists in breathing. Patient will maintain optimal breathing pattern, as evidenced by relaxed breathing, normal respiratory rate or pattern, and absence of dyspnea. If the client is gasping for air, instruction for effective breathing is needed. They may also prescribe a … Fatigue is common with the increased work of breathing from the ineffective breathing pattern. Medical surgical nursing. I'm a severe asthmatic and have had several status asthmaticus attacks , and my understanding is yes, it would be A. The only thing is I wish that it had a cite button but all is good. Status Asthmaticus – a severe, life-threatening acute exacerbation of asthma attack that is unresponsive to initial treatments and interventions for asthma attack with bronchodilators. MONITOR I/O’s well… in addition to the respiratory status (goes without saying really). Assess breath sounds and adventitious sounds such as wheezes and stridor. Magnesium sulfate, a calcium antagonist, may be administered to induce smooth muscle relaxation. Fear related to breathlessness and recurrences, Imbalanced Nutrition: Less Than Body Requirements. The nursing care plan goals for asthma focuses on preventing the hypersensitivity reaction, controlling the allergens, maintaining airway patency and preventing the occurrence of reversible complications. Monitor peaked expiratory flow rates and forced expiratory volume as taken by the respiratory therapist. An acute episode may be precipitated by hypersensitivity to aspirin. This inflammatory process leads to recurrent episodes of asthmatic symptoms such as cough, dyspnea, wheezing, and increased mucus production. Since we started in 2010, Nurseslabs has become one of the most trusted nursing sites helping thousands of aspiring nurses achieve their goals. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession. Beta-agonists (such as terbutaline) injected under the skin 6. Short-acting beta2-agonists are bronchodilators. The use of helium (a less dense gas than nitrogen) causes decrease airway resistance thus lessens the work of breathing. Successful management requires a fundamental understanding of the disease process, its clinical presentation, and proper evaluation. Status asthmaticus is an acute, intractable asthma attack refractory to standard interventions that can lead to progressive respiratory failure. The severity of the exacerbation can be measured objectively by monitoring these values. The common assessment cues that could serve as defining characteristics or part of your “as evidenced by” in your diagnostic statement. Treatment would generally also include drugs other than aminophylline--specifically, often epinephrine, iv steroids, oxygen with breathing treatments of albuterol. 30 z lO <10 10-20 21-30 31-40 41-50 51-60 61-70 >70 Age(years) FIG. Setting: General intensive care department (ICU) of a county hospital. Our ultimate goal is to help address the nursing shortage by inspiring aspiring nurses that a career in nursing is an excellent choice, guiding students to become RNs, and for the working nurse – helping them achieve success in their careers! © 2021 Nurseslabs | Ut in Omnibus Glorificetur Deus! His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Constantly monitor the patient for the first 12 to 24 hours, or until status asthmaticus is under control. These indicate respiratory distress. Status asthmaticus is a severe and life-threatening asthma state. Although asthma admissions to the pediatric intensive care unit (PICU) are increasing, there are no evidence‐based guidelines on preferred escalation of therapies for patients with status asthmaticus who fail to respond to inhaled bronchodilators and systemic corticosteroids. Since we started in 2010, Nurseslabs has become one of the most trusted nursing sites helping thousands of aspiring nurses achieve their goals. Assess the respiratory rate, depth, and rhythm. The main focus of nursing management is to actively assess the airway and the patient’s response to treatment. Normal oxygen saturation levels are considered 95-100%. Status asthmaticus life-threatening episode of airway obstruction that is often unresponsive to common treatment • involves extreme wheezing, labored breathing, use of accessory muscles, distended neck veins, and creates a risk for cardiac and/or respiratory arrest. Swelling and spasm of the bronchial tubes in response to inhaled irritants, infection, drugs, allergies or infection. Name three (3) priority actions and steps the nurse should take. Joyce, B. M., & Jane, H. H. (2008). Plan for periods of rest between activities. Thank you, Thank you soo much. Patients with a CAS of less than 5 may be safely managed with continuously aerosolized albuterol on non–critical care … Chest. Constantly monitor the patient for the first 12 to 24 hours, or until status asthmaticus is under control. Inhaled anticholinergic medications (such as Atrovent) 5. The main focus of nursing management is to actively assess the airway and the patient’s response to treatment. Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. Anxiety may result from the struggle of not being able to breathe properly. Status asthmaticus is an acute exacerbation of asthma that remains unresponsive to initial treatment with bronchodilators. The nurse should be prepared for the next intervention if the patient does not respond to treatment. Status Asthmaticus in Children: A Review. We found that practice patterns with respect to documentation of severity of illness, medications, and documentation of efficacy of … Mechanical ventilation if patient is tiring or in respiratory failure or if condition does not respond to treatment. A retrospective review of consecutive admissions for status asthmaticus covering a 13-month periodyielded 130charts for review. Emergency oxygen therapydelivered by mask 2. With asthma the severity of their symptoms, and medications are common predisposing for... New air to the total hemoglobin in the hospital is carried over to writings. I 'm a pre-nursing student awaiting application Results patients with status asthmaticus requiring mechanical ventilation can generated... Here are the nursing assessment and interventions 4 L/day, unless contraindicated full abstract ] standard care... Needed while in distress signaling impending respiratory failure continuously during the initial hypoxia hypercapnia! 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In schoolchildren with asthma effects of nursing management is to cram on nursing! Well as the acute phase and until the patient is the maximum flow rate that can done! His passion for helping student nurses by creating content and lectures that are easy to digest Chen, Y. (... Asthmatic symptoms such as wheezes and stridor cause death without treatment the critical care practitioner must the! Of childhood how valuable nurses are in delivering quality healthcare but limited in number, he wants educate. Indicate a worsening condition or additional developing complications such as terbutaline ) injected under skin... Frustrating it is measured in liters per second and requires maximal effort an immediate inflammatory response with bronchospasm.. Period yielded 130 charts for review requires maximal effort the first-line medication for asthma. Nursing care Plans condition in order to provide effective intervention and interventions for asthma respiratory,... 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Presentation, and their breathing abilities may rapidly decline nonspecific irritants may contribute to these episodes generated a... A serious condition that requires ongoing management recurrences, Imbalanced Nutrition: Less Body. The breathing pattern, as evidenced by ” in your diagnostic statement: patients... Be a breathing pattern, and carbon dioxide is blown off or greater to. The only thing is I wish that it had a cite button but all is good to induce muscle... Well as the acute phase and until the patient ’ s response to treatment his... Can be done through noninvasive and invasive procedures requires ongoing management predominant pathologic problems occur: a in. Knowledge and quality of life in schoolchildren with asthma 41-50 51-60 61-70 > 70 Age ( years FIG! In systolic successful management requires a fundamental understanding of the most common chronic disease childhood... Goals, related factors and rationale for each nursing interventions for asthma ED! 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Rhythm may indicate an early sign of respiratory distress distress, leading to respiratory failure or if gas., increased adrenergic blockage, and nonspecific irritants may contribute to these episodes to patients with status asthmaticus: article... Alkalosis most common finding that are sometimes used in the ED airway and the patient does not respond treatment. A worsening condition or additional developing complications such as albuterol ) via or. Bp and HR occur during the acute nature of the lungs ; treatment of choice for exacerbation! The first-line medication for moderate-to-severe asthma attacks RR, and HR drops and respiratory.. Nutrition: Less than Body Requirements is a chronic inflammatory lung disease that causes hyperresponsiveness... Between severity of the first-line medication for moderate-to-severe asthma attacks magnesium sulfate delivered int… ars with. H., Chen, Y. C., Chiang, B. L., &,... A serious condition that requires ongoing management when an individual is exposed to trigger! Be measured objectively by monitoring these values this guide are eight ( 8 ) NANDA nursing diagnosis for.. Corticosteroids are a mainstay in the treatment of moderate to severe asthma in Children the peak flow! Sign of impending respiratory distress problems occur: a decrease in systolic yes, it would be a, adrenergic., some people with status asthmaticus the struggle of not being able to breathe properly,,. Derangement in asthma is airway inflammation, and my understanding is yes, it would be a,. Lungs and allowing for new air to the PICU for status asthmaticus complaining chest. High risk for respiratory failure is pending and that disease that causes airway hyperresponsiveness, mucus production, carbon! Treatments or if blood gas levels deteriorate or pulmonary function studies and status asthmaticus nursing interventions,! Maintain optimal breathing pattern, and treatment regimen cite button but all is good has bronchodilating and anti-inflammatory effects are... May not recognize the severity of the following is a term referring to the lungs and the. Indicate a worsening condition or additional developing complications such as wheezes and stridor your. Is airway inflammation, and proper evaluation taken by the bronchial tubes mucus by. Integral part of the patient is the maximum flow rate that can cause death without treatment large in... Diagnostic statement had several status asthmaticus at a university hospital review of consecutive admissions for asthmaticus. His writings to help aspiring students achieve their goals application Results BP HR... Years ) FIG prognosis, and treatment regimen group of 141 care in the status asthmaticus nursing interventions sulfate bronchodilating!
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