Case Study - Asthma

Running head: NURSING
Case study- asthma
Name of the Student
Name of the University
Author note

1NURSING
Part 1
Acute care refers to the branch of healthcare services where the patients are provided
short-term treatment modalities, with the aim of effective management of an episode of
illness or severe injury. Acute care services are typically delivered by several healthcare
professionals, who are employed in surgical and medical specialities, and require stay of the
patient in hospitals, ambulatory services, emergency departments, or urgent care centres
(Kelly, Runge & Spencer, 2015). In addition, acute care nurses work in collaboration with
patients for a limited period of time and their duties generally encompass delivering
individualised care services. This assignment will focus on a comprehensive health
assessment of a patient who had been presented to the emergency department of the hospital
with pneumonia.
Case presentation- Mrs X (pseudonym), a 55-year-old female resident of Northern
Tablelands, New South Wales had been presented to the emergency department with
presenting complaints of dyspnoea, fever and cough for the past seven days. She had been
stated well by her family members until two days earlier, when she reported the onset of
sudden mild sore throat, nasal stuffiness, and a cough that was produced moderate amount of
clear sputum. Originally, her family members thought she was getting cold, however, on
observing a deterioration in her symptoms, they immediately decided to admit her to the
emergency department, since she became short of breath, for the past 20 hours.
They also decided to seek immediate physician assistance owing to a sudden increase
in her body temperature to 38.3°C, concomitant with spasms of coughing, which were found
to produce purulent secretions. At the time of leaving for the emergency department, the
patient also reported observing minute flecks of red blood in her sputum.

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Relevant patient history- It is April. X resides in a house in the district with her
husband, a son, his wife, and two granddaughters. Her son, daughter-in-law and
grandchildren are completely immunised. However, her elder granddaughter aged 9 years, is
recently recovering from a persistent and “nagging” cough that has affected her for the past
10-15 days. The family also reports having a pet parakeet, aged not more than four years that
appears to be healthy. In recent times, X has not travelled outside her district and is has been
working as a school administrator for the past 20 years. She generally smokes two packets of
cigarette each day and has been an active smoker since her teenage years. On enquiry, it was
also found that she often produced purulent sputum especially during the winter, after
awaking from sleep.
Medical history- The patient reported absence of any familial disorder, or traumatic
events. However, she had been hospitalised in another acute care hospital for two days on
account of a sudden fall from the bed, one month earlier. There are no reports for drug
intolerance or hypersensitivity and the only medication that she is currently being
administered is aspirin for management of sporadic headaches. She had also been addicted to
alcohol during her teenage years, but refrained from any alcohol consumption after her
pregnancy.
Health assessment- Comprehensive health assessments are primarily conducted in
such acute care settings and comprise of examining the health risks, medical history,
behavioural and social influences, in addition to the preferences and needs of the patients
(Forbes & Watt, 2015). These information are generally collected by conducting a thorough
review of the medical records of a patient, besides conducting an interview with the patient
and family members. Informed consent forms a crucial aspect of acute care nursing where
the patients and family members are provided adequate information by the healthcare
providers on the actions that are intended to be implemented, and their potential advantages

3NURSING
and risks (if any) to patient health and safety. After obtaining voluntary consent from the
patient, a comprehensive health assessment was conducted within an hour of admission of the
patient X, to the emergency department.
The Airway, Breathing, Circulation, Disability, Exposure (ABCDE) assessment
framework was selected for evaluating the present health condition of X, owing to the fact
that it has been identified as a systematic approach that facilitates instantaneous assessment
and treatment of patients who are critically ill or injured. The primary reason for conducting
ABCDE assessment was to break down the multifaceted clinical scenario into manageable
parts, in order to establish a final diagnosis and implement necessary treatment modalities
(Clarke, 2014). The approach has been extensively accepted and utilised by numerous critical
care specialists, emergency technicians, and traumatologists (Stanley et al., 2015). The
framework serves the purpose of a healthcare algorithm for resuscitation, which in enhances
the quality and speed of treatment (Boehm, Vasilevskis & Mion, 2016). The table given
below provides an overview of the physical parameters that were detected in the patient X,
upon adoption of the ABCDE approach:
Parameters Assessment
A (airway) Breath sounds and voice
B (breathing) Respiratory rate (12-20 breaths/minute),
movement of the chest wall, cheat
percussion, pulse oximetry and lung
auscultation
C (circulation) Colour of the skin, capillary refill time,
sweating, palpation of pulse rate (60-100
beats/min), electrocardiography, blood
pressure (120-80 mmHg), and heart