Get this App offline and editable on your phone

iPhone & iPad | Android | PC | Mac

Asthma

  • Dx labs

    • clinical diagnosis if you're confident
    • PFTs (low FEV1 and FEV1/FVC, alleviated with albuterol)
  • Outpt tx

    • albuterol prn
    • add ICS if: daily symptoms/albuterol usage or 2 nocturnal awakenings per week
    • add LABA if: symptoms/albuterol usage throughout the day or nightly awakenings
  • ED tx

    • albuterol 5mg neb q20min x 3 doses, followed by prn q20 min
    • methylprednisone IV 60mg q12h
  • Admission orders for acute exacerbation

    • Admit: Floor, ICU if impending respiratory failure
    • Diagnosis: Asthma Exacerbation
    • Condition: Stable or Guarded, Critical if ICU
    • Vital Signs: Routine, O2 sat
    • Allergies:
    • Nursing: Check peak expiratory flow qday, O2 to maintain sat > 90
    • Diet: Regular
    • Activity: As Tolerated
    • Labs:
      • CBC, Chem qday
      • if pneumonia: blood culture, sputum culture
      • if on theophyline: check levels
      • ABG
      • EKG if age > 50, heart disease or COPD
      • CXR
    • IV: None if tolerating PO
    • Special: Respiratory therapy consult
    • Medications:
      • Methylprednisolone 125 mg IV now
      • Prednisone 60 mg PO qd
      • Albuterol nebulizer q 4 hours
      • Ipratropium nebulizer q 4 hours
      • Albuterol nebulizer q 1 hour prn wheezing or SOB
      • If smoker: Nicotine patch 14 mg applied qd
      • Avoid sedatives
    • Discharge
      • education: peak flow monitor, triggers, meds
      • smoking cessation
      • adjust meds accordingly
      • f/u 1 week
  • ROS

    • frequency of symptoms
    • night time awakenings
    • number of asthma hospitalizations
  • Px

    • pulm, wheezing
    • ENT (pale swollen nasal mucosa, nasal polyps)

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.