Nursing Assignment - Vital Signs of Rising Blood Pressure

1Running head: NURSING
Nursing
Name of student:
Name of university:
Author note:

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Q 2.
Upon recording the vital signs of Elsie it was found that her blood pressure was
150/90 mmHg, pulse was 126 bpm and respiration was 30 and shallow. Her body temperature
was 37.3 C while her pulse oximeter reading was 92%. The readings of the patient’s blood
pressure indicate that the patient has been suffering from high blood pressure. The normal
blood pressure of an adult human being is 120/80 mmHg. A blood pressure of 140/90 is
considered as high blood pressure, or hypertension. The patient is at stage 1 of hypertension
since the blood pressure of Systolic mmHg 140-159, or Diastolic mmHg 90-99 is considered
for this condition (Mancia et al. 2013) Harvard style followed. The high pulse of 126 bpm
indicates that the patient was suffering from Tachycardia. Tachycardia is the condition in
which the heart rate of the patient exceeds the normal resting state of 100 bpm (Sapp et al.,
2016). Asthma is a cause of high blood pressure and increased heart rate. When a patient
suffers difficulty in breathing, the lungs do not function properly, and thus the heart has a
faster rate of pumping for cycling more blood through the body (Fofanova et al. 2016)
Harvard style followed..
The pathology results of the arterial blood gas (ABG) was pH at 7.49, paO2 74
mmHg, paCO2 22 mmHg, HCO3 22mEq. Sputum and blood tests reveal elevated levels of
eosinophils and elevated IgE. The level of PaO2 indicates the amount of oxygen dissolved in
the blood. The norma value of it is 80-100 mmHg (Morton et al. 2017) Harvard style
followed.. In the present case, the patient was suffering from lower levels of paO2 at 74
mmHg. This concluded that patient had lower levels of oxygenation in blood. Further, the
patient was having respiratory alkalosis. This condition is defined by a pH greater than 7.45
with a PaCO2 less than 35 mmHg (Basu, Dasgupta and Routray 2016). Factors causing
hyperventilation result in such alkalosis condition. Elevated levels of IgE in a patient
suffering from asthma is natural. Such an elevated level is the result of allergies wherein the

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body produces the antibody or immunoglobulin against the foreign particle entering the body
(Tuano et al. 2015). An increased level of eosinophil, a component of the immune system is
an indication of allergic diseases, such as asthma (Fulkerson and Rothenberg 2013).
Q 3.
The laboratory results of Elsie revealed Serum glucose: 5.0 mmol/L, Blood urea
nitrogen: 6.2 mmol/L, Serum creatinine: 68 micromol/L, Serum sodium: 136 mEq/L, Serum
potassium: 4.5 mEq/L, WBC count 8,000/mm3, RBC count 4,400,000/mm3, Platelet count:
300,000/mm3, Haemoglobin: 132 g/L, Haematocrit: 34.7%, Pulse oximeter reading: 85%.
The ABG report indicated pH 7.32, pO2 55 mm Hg, pCO2 60 mm Hg, HCO3- 27 mEq.
FEV1/FVC was at 65%.
The normal blood glucose level for non-diabetics is between 3.9 and 5.5 mmol/L. The
mean normal blood glucose level is about 5.5 mmol/L (Hall 2015). The patient was therefore
found to be non-diabetic. The blood urea nitrogen at 6.2 mmol/L was less than the normal
range of 7 to 20 mg/dL (Sherwood 2015). Normal levels of serum creatinine in females are
45-90 micromol/L (Daugirdas and Depner 2017). This implied that the patient had normal
levels of serum creatinine and thus normal renal functioning. If the kidneys are impaired the
creatinine level in the blood rises as a result of poor clearance of creatinine. The normal
sodium level is between 135 to 145mEq/L, while normal potassium level is between 3.6 to
4.8mEq/L (Shier, Butler and Lewis 2015). The patient, therefore, had normal electrolyte
balance. The balance of electrolyte is pivotal for maintaining normal body functioning and
physiological functioning. The normal value of RBC and WBC in humans are 3.6 to 5.0
million/mm3 for female and 3,7000-10,500/mm3 respectively.A normal hematocrit is 35-
45% for women. Normal levels of hemoglobin in healthy women are 120-160 g/L. A normal

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platelet count is about 150,000 - 400,000/mm3 (Cardenas and Olson 2017). The patient,
therefore, had normal levels of WBC and RBC, hemoglobin, platelet and hematocrit.
The ABG report indicated that the patient had been suffering from respiratory
acidosis. This condition is defined by a pH less that 7.35 and the paCO2 greater than 45
mmHg. Acidosis is caused due to the accumulation of CO2 as a result of the production of
carbonic acid. Such condition arises due to hypoventilation through prevention of exhalation
of CO2. It is considered as a medical emergency, and acute acidosis can be caused by airway
obstruction related to asthma (Sherwood 215). Pulse oximetry reading determines the SpO2
values. A healthy human being has a normal blood oxygen saturation levels (SpO2) of 94%
to 99%. In case a patient is suffering from mild respiratory disease, the SpO2 should be 90%
or above (Hall 2015). Since the patient had the reading at 85%, it indicated that the patient
was suffering from chronic respiratory illness and that she had a low oxygen saturation level,
demanding oxygen therapy. The FEV1/FVC at 65% indicated that the patient could breath
out only 65% of the inhaled air in the lungs in a second. In patients of obstructive lung
disease, the FEV1 is reduced due to an obstruction of air escaping from the lungs.
Q 4.
Elise was administered salbutamol 5 mg in normal saline (NaCl) via a nebulizer along
with IV therapy 5% dextrose. Upon complaint of chest tightness, she was given a stat dose of
500mcg ipratropium bromide via a nebuliser. 5 ml of 50% magnesium sulfate solution in 100
ml of NaCl was commenced. In addition, 100mg of IV hydrocortisone was also administered.
Salbutamol is the medication known for treating respiratory distressing conditions such as
asthma, bronchoconstriction, and chronic obstructive pulmonary disease. It is indicated for
bronchospasm with obstructive airway diseases that are reversible. The medicine belongs to
the class of bronchodilator medications and more precisely, beta2- adrenergic agonists. The

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mode of action of the medicine is through opening up the large and medium airways in the
lungs. The medicine also increases the conductance of channels that are sensitive to
potassium and calcium ions, as a result of which the bronchial smooth muscles are relaxed.
The most common method of administering the drug is through a nebulizer (George 2017).
IV dextrose is injected into the vein for replacing the loss of fluids and providing
carbohydrate to the body. It is a form of nutritional support given to patients suffering from
acute medical conditions such as asthma.
As the patient suffered chest tightness even after salbutamol was administered, she
had to be given ipratropium bromide. Elise had been reported to have audible wheezing.
Ipratropium is indicated in patients from controlling the symptoms of chronic pulmonary
diseases such as shortness of breath and wheezing. The drug is an anticholinergic
bronchodilator that inhibits the increase in intracellular concentration of cyclic guanosine
monophosphate (cyclic GMP). By blocking the muscarinic receptors of acetylcholine, the
drug exerts its impact. Magnesium sulfate solution was administered in NaCl solution as it
inhibits smooth muscle contraction, decreasing histamine release from mast cells, and
inhibiting acetylcholine release (Lee et al. 2016).
Hydrocortisone injection is given to a patient for treating the symptoms of severe
allergy. Bronchial airway inflammation is a chief pathological feature of asthma.
Corticosteroid, when administered to the patient, has an anti-inflammatory action on the body
a the airways carrying air to the lungs are relieved of allergic reactions (Elhanbly et al. 2017).
In addition, there is a decrease in the amount of mucus secreted from the bronchial tubes, and
as a result, the patient can breathe easily.
Q 5.

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Salbutamol has a number of side effects that are to be considered after administering
the drug. These include coughing, dizziness, difficulty sleeping, faster heartbeat, irritated
throat, flushing, fatigue, nausea, headache, restlessness, tremor, nervousness, and weakness.
Though the side effects do not persist for long, they might lead to serious health
complications. Other severe impacts are vomiting, muscle cramps and difficulty urinating.
Patients with diabetes and thyroid disease must not be administered the drug. There can be an
interaction between salbutamol and other drugs such as atomoxetine, aminophylline,
betahistine and methylphenidate, oxymetazoline. The most important drug-food interaction
for salbutamol is that with caffeine. The interaction redcues the effectiveness of the drug
(Lehne and Rosenthal 2014).
Ipratropium bromide might lead to certain unwanted effects along with the needed
impacts. The more common side effects include bladder pain, blood in urine, cough
producing mucus, difficulty in urination, difficulty in breathing, shortness of breath, tightness
in chest, side pain. The less common side effects include loss of voice, body ache, chills, ear
congestion, headache, fever and sore throat. Some rare side effects include eye pain, fainting,
and constipation, nausea and vomiting. There are a number of possible drug interactions with
ipratropium. Taking ipratropium with medications, such as anticholinergic medications,
acetylcholinesterase inhibitors, or pramlintide, can lead to health problems. Such interactions
increase the risk of side effects and decrease the effectiveness of the medications. The
medicine is not to be taken with alcohol and tobacco (Adams and Urban 2015).
Hydrocortisone is a kind of steroid which is used to treat problems such as allergies,
skin irritation, arthritis, ulcerative, lupus, psoriasis or breathing disorders. There are some
common side effects of this drug which includes insomnia, acne, dry skin, bruising, excess
sweating, dizziness, spinning sensation, stomach pain, bloating, changes in location and
shape of body fat, muscle weakness, mood changes, menstrual cycle changes, slow healing of

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any wound, nausea, heartburn, glaucoma, osteoporosis and convulsions. It may interact with
diuretics, insulin or other oral drugs for diabetes, rifampicin, seizure medications,
cyclosporine, and ketoconazole. Hence it must be taken only by the advice of a registered
medical practitioner (Karch and Karch 2016).

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