The client with asthma should be taught which of the following is one of the most common precipitating factors of an acute asthma attack?
A. Occupational exposure to toxins.
B. Viral respiratory infections.
C. Exposure to cigarette smoke.
D. Exercising in cold temperatures.
Correct Answer: B. Viral respiratory infections.
The most common precipitator of asthma attacks is viral respiratory infection. Clients with asthma should avoid people who have the flu or a cold and should get yearly flu vaccinations. Asthma is a condition of acute, fully reversible airway inflammation, often following exposure to an environmental trigger. The pathological process begins with the inhalation of an irritant (e.g., cold air) or an allergen (e.g., pollen), which then, due to bronchial hypersensitivity, leads to airway inflammation and an increase in mucus production. This leads to a significant increase in airway resistance, which is most pronounced on expiration.
Option A: Environmental exposure to toxins or heavy particulate matter can trigger asthma attacks; however, far fewer asthmatics are exposed to such toxins than are exposed to viruses. Asthma comprises a range of diseases and has a variety of heterogeneous phenotypes. The recognized factors that are associated with asthma are a genetic predisposition, specifically a personal or family history of atopy (propensity to allergy, usually seen as eczema, hay fever, and asthma).
Option C: Cigarette smoke can also trigger asthma attacks, but to a lesser extent than viral respiratory infections. Asthma also is associated with exposure to tobacco smoke and other inflammatory gases or particulate matter.
Option D: Some asthmatic attacks are triggered by exercising in cold weather. The overall etiology is complex and still not fully understood, especially when it comes to being able to say which children with pediatric asthma will carry on to have asthma as adults (up to 40% of children have a wheeze, only 1% of adults have asthma), but it is agreed that it is a multifactorial pathology, influenced by both genetics and environmental exposure.
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