Case Study: Analysis of Helen Johnson's Asthma and Chest Pain

This case study analyzes the medical case of Helen Johnson, a 32-year-old patient suffering from asthma and chest pain, presenting at Avenue Hospital. The paper delves into her medical history, diagnosis through physical tests like peak flow and spirometry, and the complexities of managing these c...Read More

Running head: ANALYSIS OF MRS. JOHNSON'S CASE STUDY 1
Analysis of Helen Johnson’s Case Study
Student’s Name
Institutional Affiliation

ANALYSIS OF MRS. JOHNSON’S CASE STUDY 2
Introduction
Acute Care refers to the provision of short-term urgent medical care to the patients
(Salimi et al., 2017). The treatment mode is active as it targets a severe ailment such as Asthma.
The method of care involves the management of evaluation of the clients with acute conditions.
Afterward, nurses prepare the patients for discharge. Moreover, the care providers train the
patients on preventing further infection by the disease. The acute care nursing skills enable the
nurses to improve the quality of care. The technique starts with diagnosis followed by
management of the emergency condition.
Helen Johnson is a 32 years old suffering from Asthma and chest pains. The paper looks
at the patient's history. Additionally, the paper discovers Helen's diagnosis and past medical
records. The two complications are involved since they require a series of consistent medical
attention. Moreover, they are epidemic and have numerous risk factors. Appropriate nursing
management is necessary for managing the two scenarios. Furthermore, there are strengths and
weaknesses of the scenes. This paper looks at the diagnosis, management, best practice
guidelines, and areas for improvement in Asthmatic attack and chest pain.
Diagnosis
The family members of Helen brought her into the emergency department of Avenue
hospital with chest pain and asthmatic attack. Helen had been complaining of asthmatic in her
chest. After one day, she started experiencing chest pain. The week before, Helen had been
wheezing and complained about her inability to breathe correctly. After few hours, she began to
feel severe pain in her chest area. Helen also says that she feels occasional flare-up emotions.
Helen admits that she has encountered gases and dust particles both at home and at the
workplace. Her medical history indicates, breathing complications, tightness in the chest, and

ANALYSIS OF MRS. JOHNSON’S CASE STUDY 3
persistent coughing. However, Helen states occasionally experience difficulties when sleeping
due to the breathing complications. Her records indicate that she had been complaining about
pulmonary and lung infections.
During the diagnosis process, the physician has to conduct random physical tests. The
physician should ask the patient about the signs and symptoms (Salimi, Henderson, Morgan,
Jalaludin, & Johnston, 2017). The physicians conducted both pick flow and spirometry tests on
Helen (Salimi et al., 2017). The pick flow determines the ease of breathing of the patient. Low
pick flow readings indicate difficulty in breathing. However, high reading suggests low asthma
attacks. Helen has shallow interpretations implying that she has asthma. She should avoid
crowded places to improve her breathing capacity. Spirometry test checks on the circumference
of the bronchioles (Beasley et al., 2016). Asthmatic conditions narrow the boundary hence
restricting gaseous exchange between the lungs and the atmospheric air (Beasley et al., 2016).
Helen has restricted airspace thus causing a restriction in the amount of air that she breathes.
The complexity of Asthma and Chest pain
Asthma is a complex disease due to the nature in which it manifests itself in the body
system. The condition interferes with the air track hence complicating the process of breathing
(Gibson, & McDonald, 2017). The contraction level of Asthma is elementary but complicated in
such a way that its stops inhalation. The disease results into blocking of the free movement of
atmospheric air into the lungs (Kelly et al., 2017). The signs and symptoms include coughing and
wheezing (Bell, 2017). Afterward, the patient feels that their chest is tight. Additionally,
breathing becomes difficult for the patients (Bell, 2017). The victims later develop acute chest
pain.
Nursing management of Asthma and Chest Pain

ANALYSIS OF MRS. JOHNSON’S CASE STUDY 4
St. Ann's hospital carries out a consistent treatment for the chest pain and Asthma
patients. The health facility prescribes anti-inflammatory drugs to the asthma patients. The
facility continually checks on the progress of the patients. The hospital also supports the patients
in looking after their health status. The health center also trains the patients on the correct usage
of the inhalers (McLaughlin, Kable, Ebert, & Murphy, 2016). Patients obtain the knowledge of
the causative agents of asthma from the facility. Every Australian health facility has an
obligation of supporting and encouraging the Asthmatic patients. The support enlightens the
patients about the causes of chest pain and asthma.
A proper management strategy encourages the patients to assume a significant role in
solving their medical conditions. The patients can now monitor and adequately take medications.
Moreover, the patients can lead a happy life despite the complications. The health facility
delivers tutorials on the causes, prevention, and treatment of asthma. The learning sessions
emphasize on avoiding of the causative agents and consistent uptake of medicine. Moreover, the
health center sensitizes people on the need to use the inhaler in the proper manner (Whitehead,
2017). The Staff of St. Ann also carries out regular awareness tours of the neighboring
communities. The campaigns sensitize the people on the medication of asthma and chest pain.
Additionally, the nurses teach the society about the prices of the drugs.
The health facility also provides affordable services that support the patients.
Additionally, the health center offers relevant information about the disease to the citizens. The
hospital staff encourages the family members to monitor the patients and ensure that they take
their drugs. The hospital also enhances literacy as far as asthma is concerned (Brown, Edwards,
Seaton, & Buckley, 2017). The hospital staff educates the public on the causative agents of
Asthma. Moreover, the nurses enlighten the patients on the available treatment regimens.

ANALYSIS OF MRS. JOHNSON’S CASE STUDY 5
Furthermore, the hospital trains the patients on the techniques of using the inhaler. The facility
also implements the plans of action in asthma treatment (Whitehead et al., 2017).
Strengths and Weaknesses of the Management Strategies
Strengths
The education on the proper usage of inhalants enables them to command their
rehabilitation programs. The patients can avoid causative agents such as dust and pollen grains
after schooling from the nurses. Additionally, the clinicians expose the patients on the various
treatment options. As a result, the patients make informed choices about the treatment plan that
suits their cultural beliefs. The support channels such as specific asthma management
departments assist in the treatment procedure (Elaro et al., 2016). The constant monitoring of the
symptoms enables the nurses to manage the disease. The public also gets the knowledge about
the manifestation of the disease and can report to the hospital in case of a symptom.
Weaknesses
The education plan can be less effective with the disabled patients. Communication
barriers hamper communication between the health practitioners and the illiterate patients.
Moreover, the program of ensuring equal distribution of resources is expensive to achieve. The
treatment options may contradict the preferences of the patients (Reddel, Ampon, Sawyer, &
Peters, 2017). Additionally, patients may experience difficulties in learning how to use the
inhalants. There are family members who are unsupportive and do not monitor the patients when
taking the drugs. The indifferent culture of the aboriginals complicates the treatment process for
that group of patients. The indigent patients cannot afford the medications hence suffer in
silence.

ANALYSIS OF MRS. JOHNSON’S CASE STUDY 6
In comparison with inhalants, oral medications have a narrow index of therapy (Becker,
& Abrams, 2017). Due to the low action, a patient must continuously take the drugs for a long
time to manage asthma. Long-term use of oral medication can cause severe damage to the body
such as fracturing of the bones (Elaro et al., 2016). However, oral administration of asthma drugs
deals with severe complications in a better manner compared to inhalants. The oral medicine
does not have an undesirable impact on the patients (Reddel et al., 2017). Inhalants act
immediately to correct asthma whereas the action of oral medication takes an extended period.
The inhalants are small in size and light in weight. Therefore, patients can carry them
around to any destination. Patients apply the inhalants that have adequate instructions with ease.
The portability of the inhalants makes them vulnerable to misplacement. Inhalation challenges a
select group of people when it comes to application (Reddel et al., 2017). The senior citizens,
children, and individuals with mental diseases find it challenging to use the inhalants. An
aspiratory pathway must exist for proper inhalation process. The use of inhalants affects the
people surrounding the individual. Unlike the oral medication, the person next to the patient must
notify the user of an inhalant.
Current workplace system for managing Asthma and chest pain
The St. Ann’s hospital uses methacholine to diagnose asthma (Abramson, Perret,
Dharmage, McDonald, & McDonald, 2014). The methacholine triggers asthma. The inhalation
of the drug leads to airways constrictions to a small extent. Patients who show a reaction to the
medication has asthma. Clinicians apply the diagnosis process when the tests of the lung are
negative. The diagnosis is also through the use of nitric oxide gas. Individuals having elevated
levels of the gas are having asthma. X-rays and CT scans can also reveal the presence or absence
of asthma and chest pains (Abramson et al., 2014).

ANALYSIS OF MRS. JOHNSON’S CASE STUDY 7
When the nose and the airways have abnormality or inflammation, then the individual has
asthma. Individuals who are allergic to numerous items can also have asthma and subsequent
chest pains. The range of things that an asthmatic patient can be allergic to include: pollen grains
and pets. Additional items are dust and molds (Fawcett, Porritt, Campbell, & Carson, 2017).
During diagnosis, the physician exposes the individual to either of the things. If the items trigger
a reaction out of the patient, then they have asthma. Such individuals need immediate
immunotherapy to correct the allergic reactions. Eosinophils test also checks for asthma (Fawcett
et al., 2017). The physician takes saliva or mucus sample from the individual. Individuals who
have eosinophils have asthma.
Beta medications are essential in managing asthmatic and chest attacks. The patient
inhales them to produce the desired effect. The drugs include formoterol and salmeterol
(Fawcett et al., 2017). The medications assist in clearing and opening the air track. When taken
in isolation, the Beta medicine can result in chronic asthmatic conditions. Therefore, the patients
should take the drugs together with glucosteroids (Fawcett et al., 2017). The drugs are only
applicable for mild attacks. However, acute cases must combine the two remedies otherwise beta
medicine is not appropriate. Proper management of asthma combines inhalants and oral
medication both in the long and short term to bring the healing effect.
Combination remedy can contain a mixture of salmeterol and fluticastrol. (Fawcett et al.,
2017) Another combination entails formoterol and budesonide (Fawcett et al., 2017). Moreover,
a combination of mometasone and formoterol can also arrest asthmatic attacks and chest pains
(Fawcett et al., 2017). All the blends have a beta effect and corticosteroid components. However,
the presence of the agonists in the combination remedies can lead to an asthmatic attack and
chest pains. Theophylline is another medication which can arrest chest pain and Asthmatic

ANALYSIS OF MRS. JOHNSON’S CASE STUDY 8
complications (Fawcett et al., 2017). The patient takes the drug in an oral form on a daily basis.
The medication assists in opening the bronchioles.
Theophylline dilates the muscular mass of the alveoli (Fawcett et al., 2017). The nurses
in the past century preferred this drug as compared to the present day nurses (Fawcett et al.,
2017). The current practice uses ipratropium in the management of asthmatic attack (Fawcett et
al., 2017). The drug clears and opens wide the air tracts. Therefore, the medication eases the
gaseous exchange between the lungs and the alveoli. Patients having bronchitis and emphysema
usually use the drug to correct their complications. Apart from inhalation, corticosteroids can be
in the form of oral tablets (Yang et al., 2017). The drugs get rid of inflammatory effects of
asthma and chest pains.
Best practice guidelines for asthma and chest pain management in Australia
Australian health department recommends the drugs that the paper has discussed earlier
on. The instructions resonate with the current management practices and recommendations for
asthma management. The Australian government is training the asthma patients and the
physicians on the best medication for the complication. The education strategy focuses on the
variety of asthma medication that exists in the health sector. The government is teaching the
general public on the oral and inhalation medications (Watkins et al., 2016). Additionally, the
exposure enables the patients to use the inhalers properly. Moreover, the system states the
various strengths and weaknesses of current treatment strategies.
The Australian government is carrying out a campaign on asthma awareness. The
campaign targets both clinicians and people with asthma. The drives explain the usage of the
drugs and their costs. The recognition addresses the false beliefs that people have concerning
asthma complications and the resultant treatment methods. The government is continually

ANALYSIS OF MRS. JOHNSON’S CASE STUDY 9
equipping the hospitals with asthma drugs (Boulet, FitzGerald, & Reddel, 2015). The health
department considers patients who speak correctly and walk appropriately to have Mild asthma.
However, patients who cannot talk properly have the acute asthmatic conditions. The severe
asthmatic patients cannot breathe appropriately and have low saturation rates of oxygen.
There are asthma patients who have very chronic conditions. Such individuals usually
collapse when walking and also feel dropsy. Moreover, the critically ill asthma patients have low
respiratory actions. The patients also have low levels of saturated oxygen. The mild patients
require bronchodilators as the first regiment. If their symptoms persist, the physicians should add
ipratropium in their medication (Lee, Maggiore, & Chung, 2018). The severe asthma patients
should begin their treatment with an appropriate bronchodilator. Furthermore, the patient should
take ipratropium and corticosteroids. In case of no change, the patient should see a nearby
doctor. The patient should consider an additional dosage of bronchodilators.
Areas of Improvement in asthma and chest management
St. Ann's hospital is currently carrying out sensitization campaign within the locality of
the hospital. The facility should broaden the spectrum to cover a large population. The hospital is
not accepting insurance cards from certain insurance firms. The hospital should modernize its
operation to allow insurance in their treatment processes (Basheti, Hammad, & Bosnic-
Anticevich, 2017). Australian guideline practices emphasize on educating the patients on proper
usage of inhalants (Zwar et al., 2017). The health facility should consider other means of
treatment apart from the oral medication. The best guidelines also urge the health facilities to
invest in supporting the patient to manage their conditions. St. Ann should borrow from the
instructions and monitor the symptoms of the patients. Moreover, the facility should ensure that
patients regularly take the prescribed dosage.

ANALYSIS OF MRS. JOHNSON’S CASE STUDY 10
The current diagnosis and treatment strategies by the Australian Commission of safety
and quality are appropriate. Additionally, the existing facilities employ the best approaches to
treat both mild and severe asthma patients. The two bodies have an excellent plan for the
management of the disease (McDonald et al., 2017). However, the approach of management
should follow a given procedure. The physicians should assess the intensity of the asthma
complication before commencing treatment. The physicians should prescribe an appropriate
bronchodilator to any patient regardless of the stage of infection.
Conclusion
For future asthma diagnosis and treatment, a few issues should change to ensure a
seamless process. Physicians should start taking allergy treatment seriously. They can fist run
immunotherapy to detect the presence of allergy. There are clinical shots that can help to reduce
the violent allergic reactions that asthma patients undergo regularly. The clinicians should give
patients the shorts regularly to reduce their allergic reactions. Moreover, physicians should
embrace omalizumab medication in the future. The drug is in the form of an injection. The
injection should target patients having acute asthma and allergies. The drug manipulates the
immunity of the patient. Additionally, the immune system fails to detect allergies hence
preventing hypersensitive reactions.
.

ANALYSIS OF MRS. JOHNSON’S CASE STUDY 11
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