NUR2204 Clinical Reasoning Project: Asthma Case Study of Frances

This document presents a case study analysis focused on Frances, a patient with asthma, addressing various aspects of her condition. It explores the characteristics of asthma, potential complications such as lung infections and respiratory failure, and the role of medications like Salbutamol. The case study delves into specific nursing interventions, including the use of acupressure and strategies to manage Frances's distress, anxiety, and shortness of breath. It identifies priority nursing problems, such as the lack of response to a puffer, and suggests interventions to address these issues. Furthermore, the analysis outlines strategies to prevent asthma attacks, including regular medication and breathing exercises, and details methods to evaluate Frances's improvement. The case study also considers Frances's environmental triggers, such as her friend's cat, and emphasizes the importance of managing anxiety through exercise and reduced caffeine intake. This comprehensive analysis provides a detailed overview of Frances's condition, treatment, and nursing care, making it a valuable resource for students studying clinical reasoning in healthcare.

NUR2204 CLINICAL REASONING PROJECT CASE STUDY TEMPLATE
Question 1
Asthma is a prolonged unhealthy condition of the air passage. This
attribute of asthma has express for the diagnosing, direction, and
possible hindrance of the disease (Yamauchi and Ogasawara, 2019).
The asthma diseases have some characteristics which are mentioned
below in such manner that is as follows:
 There are frequent differences in airway function in some
patients, like subbasement thrombosis, tubular atrophy,
endothelial cells inflammation, smooth muscle hyperplasia, and
gene expression.
 Airway inflammation that leads to allergic sensitization,
ventilation restriction, respiratory discomfort, and chronic
disease.
Question 2
(a) There are a range of complications which may be caused due to asthma
and Frances may face such as:
 Infection of lungs- Frances may face this issue due to asthma as
her lungs can be infected due to problem in breathing (Sly,
2019).
 Respiratory failure- In this complication level of oxygen in
blood decrease and carbon dioxide raise. Frances can face this
issue in the last stage.
Question 2
(b) In asthma patients, anatomy can occur. This is so because during asthma
attack muscles nearby airways get tighten due to which air tubes and
lungs become blocked.
Question 3
(a)
Salbutamol is also known as albuterol. The role of this medicine is to
relax medium and longer airway in lungs (Bie, Zhao and Chen, 2019). It
becomes possible due to increase of intracellular cyclic adenosine
monophosphate.
Question 3
(b)
There are different side- effects of Salbutamol such as:
 Headache
 Dry mouth
Question 3
(c)
This is the duty of nursing staff to guide patients to take the limited
dosage of this medicine. Such as children (6 to 12 years) should take 2
MG on daily base. While adult can take 24 MG daily but not more than
this limit (Boger and Fridén, 2019). As well as nursing staff should
suggest this medicine only to those patients whose health is critical.
Except these patients, they should offer any other alternate medicine
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such as bronchodilators.
Question 4 In the case of Frances, she should be treated by acupressure method.
She can be treated in a harmless manner (Huang and Matricardi, 2019).
Some key pressure points to deal with asthma are as:
 Base of thumb pressure
 Wrist pressure point
Question 5
Frances face many kinds of abnormal issues due to asthma. Most
critical is lungs sound which occurs due to fast breathing (Bogomolov,
Dragan and Erofeev, 2019). As well as this happens only to those
patients who are suffering from asthma from childhood or since many
years. This issue cannot be treated in a patient because of habit of
higher breathing. There are some short term treatments but permanent
treatment is not available.
Question 6 Frances had different issues related with their health such as distress, anxious
and very short of breath. These are major issues that impacts on her mental
as well as physical health. She stayed as her friend's house and the cat made
it much worse. It is a main problem for her because it increase distress that
impacts on her mind.
Question 7 Three highest priority nursing problems in case of Frances are defined below;
The first one is the current situation of distress and anxiety. This makes the
situation difficult for nurses as they unable to calm down and recover her
from the issue of short breathe. The second one is about the issue of asthma
from childhood. This makes the task difficult for nurses because early recover
is not possible. The third one is related to no positive response of puffer on
current health. So, nurses has to focus over other medications.
Question 8 The interventions that help in overcoming of the nursing issues are defined
below in respect of the two issues;
To address the issue of anxiety and distress, they have to focus over initial
level of medications that help in calming down the current level of situation.
Further, in guidance of medical professional, they have to continue the
treatment of main cause so able to get rid of short breath.
To address the issue of non responsive nature of puffer, they have to consult
with medical professional for immediate providence of assistance in
breathing issue. This will not only help to improve the situation but aid in
releasing her distress too.
Question 9 The two strategies that will help Frances to avoid asthma attacks are
mentioned below;
Focus over regular medication authorised from the professional. This will help
in building continuity of medication so body will not get adversely affected
while performing daily life functions. This has benefit in form of bringing

NUR2204 CLINICAL REASONING PROJECT CASE STUDY TEMPLATE
consistency.
The another strategy that will help Frances is avoidance of pollute places
along with performance of regular breathing exercises. This has benefit in
form of improving body's immunity.
Question 10
(a) There are two symptoms that would indicate that Frances’s condition has
improved. These are:
1) Use of puffer is not frequently
2) Improvement in asthma
Question 10
(b)
There are two methods that will helps in evaluating of above outcomes.
These are:
1) She is given oxygen and a beta 2 agonist via nebuliser. This will helps
them in reduction of the uses of puffer in regular basis.
2) Following exercise is a best method for reducing the issues of
asthma.
Question 11
There are two important and essential methods that will helps Frances’s by
reducing the issue of anxiety. These methods will be explained as below with
proper rationale:
1) Exercise: Exercise lowers Frances’s body’s stress hormones — such
as cortisol in the long run. It also assist release endorphins, which are
chemicals that effectively improves your mood as well as act as
natural painkillers.
2) Reduction of Caffeine intake: Caffeine is a stimulant found in tea,
chocolate, coffee and energy drinks. High doses can enhnace anxiety.
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Reference
Yamauchi, K. and Ogasawara, M., 2019. The role of histamine in the pathophysiology of
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Sly, P.D., 2019. Maternal Asthma, Pregnancy Complications, and Offspring Wheeze.
Untangling the Web.
Bie, Z., Zhao, W., Lv, Z., Liu, S. and Chen, Y., 2019. Preparation of salbutamol imprinted
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Boger, E. and Fridén, M., 2019. Physiologically based pharmacokinetic/pharmacodynamic
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Bogomolov, A.V., Dragan, S.P. and Erofeev, G.G., 2019, July. Mathematical model of sound
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Huang, X. and Matricardi, P.M., 2019. Allergy and asthma care in the mobile phone
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