In acute asthma, bronchoconstriction, mucosal edema, and mucus plugging all lead to airway obstruction and impaired gas exchange — the immediate life-threatening problem.

Nursing priority hierarchy in asthma (ABC framework):

1. Impaired gas exchange — life-threatening, top priority
2. Ineffective airway clearance
3. Anxiety (which worsens bronchoconstriction)
4. Activity intolerance
5. Deficient knowledge (addressed after stabilization)

Immediate nursing interventions:

• Position: High Fowler's or leaning forward (tripod position)
• Administer short-acting bronchodilators (Salbutamol/Albuterol nebulization)
• Supplemental oxygen to maintain \\text{SpO}_2 \\geq 94\\%
• Continuous monitoring of peak expiratory flow rate (PEFR)