Clinical Reasoning Case Study 2022

Running Head: CLINICAL REASONING CASE STUDY
CLINICAL REASONING CASE STUDY
Name of the Student:
Name of the University:
Author Note:

1CLINICAL REASONING CASE STUDY
Question 1)
Asthma pathophysiology is dynamic and includes airway irritation, occasional ventilation
blocking, and bronchial hyper responsiveness (Sullivan et al., 2016). Inflammatory response
serves as a key function in the pathophysiology of asthma. Airway inflammation includes the
association of several cell types and several mediators with airways that ultimately result in the
hallmark pathophysiological features (Baiardini et al., 2015) of the disease: bronchial
inflammation and airflow restriction that result in repeated symptoms of cough, wheeze and
shortness of breath. Allergic reactions remain critical among all social influences (Shams &
Epstein, 2019). As described in the case study, Frances says that she had a terrible asthma as a
child, but she's been much improved in the last few years. In fact, the new asthmatic condition
intensified with the inclusion of their cats in her friend's room. The cats' hair may be one of the
allergens responsible for causing her asthma. The cause of airway inflammation in asthma can
be acute, subacute, or persistent, and the involvement of airway oedema and mucus production
can also lead to airflow congestion and bronchial reactivity.
Question 2)
a)
The two risks with asthma that Frances may experience involve her being faced with
chronic issues affecting her lungs, like pneumonia (Torres et al, 2015) and becoming exhausted,
which could result in her under-performance or loss of function. It may contribute to psychiatric
issues, including tension, anxiety, and depression.
b)
Asthma doesn't quite cause pneumonia directly, although patients with recurrent lung
conditions are more prone to experience pneumonia due to prior pulmonary disease or
weakening of lung tissue. Of the same cause, a person with asthma can have more serious effects
and risks with colds and flu. Numerous studies indicate that inhaled corticosteroids (Bansal et
al., 2015), which serve as the primary treatment choice for asthma, may raise the risk of
contracting pneumonia or other respiratory infections. Typical asthma flare-ups include hacking,

2CLINICAL REASONING CASE STUDY
wheezing and a sense of tightness in the lungs. Decreased lung activity results in trouble
breathing and elevated heartbeat. The wheezing may be high-pitched and whistling. While
asthma has no remedy, symptoms appear to react well to medication and effective therapies.
When microbes or viruses multiply inside the lung tissue, the body's innate immune defenses
tend to fill the lungs with mucus (Torres et al., 2015). It makes breathing more difficult and leads
a person to cough. The mucus enters the airways that constrict in reaction to infection, creating a
loss of oxygen flow in the body. As a consequence, the muscles continue to expend additional
energy, which may cause chest pressure worse.
Question 3)
a)
Studies have projected that salbutamol (Ullmann, Caggiano & Cutrera, 2015) has a fair
and equitable effect on beta2-adrenergic receptors particularly in comparison to isoproterenol.
While beta2-adrenoceptors seem to be the prevalent adrenergic receptors in the bronchial smooth
muscle and beta1 adrenoceptors are the prominent receptors in the heart, beta2-adrenoceptors in
the human heart are about 10% to 50% of the overall beta-adrenoceptors. The specific
mechanism (Zhou et al., 2017) of these receptors has not been identified, but their existence
gives rise to the likelihood that even selective beta2-agonists can have cardiac consequences.
Regulation of beta2-adrenergic receptors on the smooth muscle of the airway contributes to the
development of adenyl cyclase and an rise in the intracellular concentration of cyclic-3′,5′-
adenosine monophosphate (cyclic AMP). Salbutamol relieves the relaxed tissues of both
airways, from trachea to terminal bronchioles. This rise in cyclic AMP contributes to the
activation of protein kinase A, which also prevents myosin phosphorylation and reduces
intracellular ionic calcium concentrations, culminating in stabilization.
b)
Anxiety and palpitation are the most frequent side effects (Baiardini et al., 2015)
associated with salbutamol.
c)
With side effects, Frances can feel anxious or nervous along the way and experience an
irregular heart rate. The primary duty of the nurses will be to test (Cabilan & Boyde, 2017) and

3CLINICAL REASONING CASE STUDY
validate the order of the doctor. Secondly, there is a need to uphold the freedoms in the
administration of drugs, such as providing the correct drug to the correct individual and trying to
use the best path and at the right moment. Surveilling the vital stats of the patient as well as the
serum electrolytes, ECG and thyroid function test results need to be monitored and prescribing
the drug correctly must be achieved, because adverse reactions and tolerances that occur with
any administration (de Sousa et al., 2015). The side rails must be lifted as the patient can feel
anxious and drowsy due to this medication. In fact, it will be ensured that the space is well
illuminated and that the individual has a person next to them in the event of vertiges. This should
be monitored to determine the pulse for pacing and to include oral treatment. Eventually, upon
inhalation, the patient must gurgle to get rid of the uncomfortable aftertaste of the inhalation.
Nurses may need to auscultate the lungs for the occurrence of adventitious breathing noises that
may signify pulmonary edema, airway obstruction or bronchospasm. In fact, the person will be
checked in a certain relaxation role to promote optimal rest and sleep.
Question 4)
The nurses will track critical data and determine France's respiratory condition by
tracking the extent of signs, as well as by observing the rhythm of coughing and wheezing.
Nurses will track critical data and determine France's respiratory condition by tracking the extent
of signs, as well as by observing the rhythm of coughing and wheezing (de Sousa et al., 2015). It
is important to determine the respiratory condition of the patient by evaluating the extent of the
symptoms. In fact, the description of the medications that Frances is actually consuming and
prescribing as indicated. Frances need to be continued to be checked on for reactions to such
drugs, so an antibiotic might be used if the patient has an ongoing respiratory infection.
Question 5)
Wheezing (Shimoda et al., 2017) can result from concentrated or diffuse airway
restriction or congestion from either the larynx level to the small bronchi. Airway restriction can
be induced by bronchoconstriction, mucosal edema, exterior compression, or partial blocking of
the tumor, foreign body, or tenacious secretions. Oscillations or movements of nearly closed
airway walls are assumed to induce wheezes. Air flowing through a compressed part of the