Salbutamol Use and Asthma Outcomes
Added on 2020-04-07
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Running head: NURSING ASSIGNMENTAssessment 2- Case StudyName of the StudentName of the UniversityAuthor Note
1NURSING ASSIGNMENTIntroductionStatus asthmaticus is a severe form of prolonged asthma attack that makes people fail torespond to usual treatment methods. Asthma is a chronic lung disease where the respiratoryairways become narrow and inflamed (Pawankar et al. 2012). The case study reports an incidentof acute asthma attack on a patient Ms. Elise Wattle and he treatment upon admission to theemergency department.Answer 1Asthma is a chronic inflammatory disease associated with the lungs and the airways. Itaffects more than 300 million people worldwide, belonging to all age groups (Ferkol andSchraufnagel 2014). It develops due to inflammation and swelling of the airways that obstructsairflow and leads to the production of thick and sticky mucus from the airways. The muscles inand around the passage constrict and this in turn reduces the diameter of the airways (Niimi et al.2013). The most common symptoms of asthma are shortness of breath, wheezing sounds, chesttightness and cough particularly during early morning or at night. These symptoms arise due toairflow obstruction that can be reversed if a patient is subjected to proper treatment.Environmental factors like exposure to several allergens like pollen, dust and dander from dogsand cats increase incidence of asthma. Other irritants that can cause asthma are exhaust fumesfrom automobiles, chemicals, molds, tobacco smoke, stress and medications like beta blockersand aspirin (Bisgaard, Jensen and Bønnelykke 2012). Elise’s condition progressed to statusasthmaticus. Such acute asthma attacks can occur when the symptoms worsen over time due tobronchospasm or muscle tightening around the airways (Papaiwannou et al. 2014). Thickermucus will be secreted and the inner lining of the airways will get more inflamed. The symptoms
2NURSING ASSIGNMENTof acute asthma attack are severe wheezing or squeaking sound, continuous coughing, rapidbreathing, retractions or tightened chest and neck muscles, difficulty in conversing, anxiety orpanic attacks, sweaty face and finger nails turning blue. Airflow limitation occurs due to bronchoconstriction, edema in the airways,hypersecretion of mucus and hyper-responsiveness in bronchi. The symptom related to problemsin conversing is demonstrated by the fact that Elise was able to speak in sentences. However, hercondition gradually worsened over time and she could barely speak short phrases. The wheezingsymptoms are quite audible, which depicts the build-up of mucus in her bronchial tubes. Duringthe acute asthmatic attack, the bronchial airways become smaller. This is responsible for thesounds that were heard when Elise spoke. The dyspnoeic symptoms observed in the patient aredue to a deficit formed between breathing demands of her body and the ability of her respiratorysystem to fulfill the demands. Persistent cough may be the effect of constriction in her breathingtubes. Answer 2Upon admission to the emergency department, Elise was kept at high Fowler’s position tofacilitate easy breathing and expansion of her chest cavity. This position allows optimaldiaphragm expansion and reduces shortness of breath. However, Elise continued to cough anddid not show any improvements. Her blood pressure was found to be 150/90 mm Hg, whichindicated stage 1 hypertension (Hoeper et al. 2013). The normal blood pressure in an adult is120/80 mm Hg. If the readings vary between 140/90-150/99, it signifies that the blood is flowingwith a higher force inside the arteries. It can lead to dizziness and will make the patient at anincreased risk on the spectrum of cardiovascular diseases (coronary heart disease, stroke, and
3NURSING ASSIGNMENTcongestive heart failure), renal failure and vision impairment (Busse et al. 2012). Her pulse wasfound to be 126 bpm. This pulse rate is considered higher than the normal levels of 60-100 in anadult. Such elevated pulse rates are referred to as tachycardia. It occurs when the heart pumpsblood at a faster rate that leads to inefficient circulation of blood to the body parts. When Eliseexperienced an acute asthmatic attack, there was deficiency of oxygen in her body cells. Herbreathlessness made it difficult for the blood to receive enough oxygen. Thus, her heart started topump rapidly in an effort to meet the oxygen demand and this gave rise to an increased pulse.Psychological factors may also be responsible for this increased pulse rate. An acute asthmaticattack often leads to panic and anxiety. That increases the heart rate and thereby elevates thepulse. Her respiration was shallow and 30. At rest the normal breathing rate in adults is 8-16 perminute. Elise exhibited a high respiratory rate, which is generally denoted by the term tachypnea.Minimal air was drawn into the lungs by the action of intercostal muscles. The asthmaticcondition of the patient is the principal reason for this vital sign. Moreover, shortness of breathand rapid pulse elevated her respiration rate (Vestbo et al. 2013). Normal human bodytemperature is around 37°C and Elise did not show much variation (37.3°C). This is due to thefact that asthma generally does not lead to chills, fever and muscle ache. Her pulse oximeterreadings were 92%. An oxygen saturation level beyond 95% is considered normal. A reductionin her oxygen levels suggested oxygen deficiency in her arterial blood, which occurred as a resultof breathing difficulty. Elevated levels of IgE and eosinophils in sputum and blood tests revealedpersistent allergy. Allergens are a major cause of asthma. Her high IgE levels indicated that sheis exposed to more than one allergy. This proves that hypersensitivity to local allergens andincrease in serum IgE are associated with her symptoms of asthmatic attack and wheezing.
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