Written personalised asthma action plans have been shown to improve outcomes of care (BTS/SIGN 2005). Further more, theophylline has a narrow therapeutic index and close monitoring of plasma theophylline levels is necessary because at concentrations above 25Âµg/ml, there is high risk of tachycardia and seizures may occur if concentrations exceed 35Âµg/ml. Start a trial to view the entire video. They need to be aware of the risks of taking and of not taking their medication (Levy and Pearce 2004). Hence, there was probably a need for a quicker rate of bronchodilation as well as faster recovery for her. Company Registration No: 4964706. This case study will focus on the maintaining a safe environment. The increase in asthma worldwide has been attributed to the increase of environmental chemicals including pesticides, solvents, and air pollutants. I basically made a bunch of 'playlists'. She was also able to speak in full sentences, and was not tachypnoeic. NEW 2015!! Overview: This case requires that the nurse recognize appropriate interventions for an asthma attack and understand the actions of respiratory medications. 10MONDAY2020 can only be used on orders that are under 14 days delivery. The liver function test showed that she had normal liver function. I feel this accurately describes my current ability in practice in relation to asthma management. 3. Cannot be used in conjunction with other promotional codes. CASE STUDY – CHAPTER 41 UPPER GI PROBLEMS. The aim of management of asthma is to keep it well-controlled without the need of rescue medications, asymptomatic, no exacerbations, no hindrance to daily activities including exercise as well as normal lung function. A case study on asthma exacerbation in a pediatric patient. Case Study: Asthma A 6 year old male has coughing with audible expiratory wheezes and dyspnea. Based on the Morisky Scale, she was compliant with her medication and she had no known drug allergy. This is not an example of the work produced by our Case Study Service. This case study was prepared for CDC by Dr. LaMar Palmer of MAS Consultants. Pharmacological Intervention in the management of AEBA2. Purpose: To review the pathophysiology of asthma, present a case study, and provide management strategies for treating this common, yet complex disorder in children and adults. However, later in the day when the chest X-ray came back, she was diagnosed with pneumonia with right parapneumonic effusion. As I will be reflecting on my practice in relation to the case study, use will be made of first person writing where ... Disclaimer: This work has been submitted by a university student. The case details have been anonymized to protect the patient's true identity. Title: COPD, Case Study #1 Author: test Keywords: COPD, Chronic Obstructive Pulmonary Disease, case study, patient care Last modified by: Asthma Case Study: Asthma is the disease which occurs in lungs and is characterized with the narrowed and seriously inflamed airways. CASE STUDY – CHAPTER 41 UPPER GI PROBLEMS. They exert an anti-inflammatory effect by inhibiting transcription of the genes for the cytokines implicated in asthmatic inflammation and hence reduce airway hyper-responsiveness. Winter is a 4-year-old girl with a history of asthma. Case discussion – Asthma pathophysiology Asthma is the most common chronic childhood disease and a common reason for pediatric emergency medical treatment. However, it is also seen that anticholinergic treatment is not particularly effective and favourable for cases of mild exacerbations of asthma as well as after the patient has been stabilized, thus is not necessary in these cases.22-24. Mild Asthma. Registered Data Controller No: Z1821391. Ipratropium bromide is one of the anti-cholinergic agents that is used widely in treatment of acute exacerbations of asthma. PEF should also be monitored pre- and post- nebulisation therapies as long as the patient is in hospital and until the asthma is well under control after discharge. If empirical treatment is to be started the preferred drugs of choice would be amoxicillin 500mg three times a day plus either erythromycin 500mg four times a day or clarithromycin 500mg twice daily. A sputum full examination microscopic examination (FEME) should be requested to identify the causative microorganisms of the lung infection. This is not an example of the work produced by our Case Study Service.You can view samples of our professional work here.. Any opinions, findings, conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of NursingAnswers.net. Registered Data Controller No: Z1821391. At the end of this presentation students will be able to: • Give a definition of asthma • Discuss what could cause asthma • Identify four triggers of asthma • Describe symptoms of an asthma flare-up • Explain three asthma treatment strategies • Develop an interprofessional plan of care for an asthma sufferer. Task: Prepare a short report on the Pathophysiology of Asthma. Oxygen saturation (SpO2) is measured using a pulse oximetry and this aids oxygen therapy as oxygen therapy is given in order to keep SpO2 levels at 94-98%. Hospital Inpatient Care Nursing Case Study After reviewing the management of the patient’s condition throughout hospital stay, it can be concluded that SK was treated adequately based on the current guidelines and evidences attainable. Publishing a nursing case study can be tough. In the United States, 8% of adults and 9.3% of children have asthma (CDC, 2014). *You can also browse our support articles here >. The purpose of the case study is to share the experience of one community as they attempt to address the problem of asthma. Current research in high-fidelity simulation demonstrates high student satisfaction, a method for active learning, a safe learning environment, an ability to recreate scenarios among several groups of students, and the ability for students to experience rare patient problems. However, there were a few issues that came to attention which were the prescribing of several drugs that were unnecessary such as diphenhydramine and theophylline. The main aim of asthma management is to control symptoms, minimise asthma exacerbations and optimise quality of life (Scullion 2005). PRO Tip – find a picture of a real person, have the students look at the picture and picture them as you go through … Registered office: Venture House, Cross Street, Arnold, Nottingham, Nottinghamshire, NG5 7PJ. More recently when seeing patients with asthma I have been able to visualise which ‘step’ they are on which has helped me to decide whether they are on the correct medication in relation to the severity of their disease. Remember that asthma is an inflammatory disease so a steroid is critical for good, effective management of an asthma patient. He suffers from full thickness burns on the upper half of his chest, back and at the back or posterior aspects of both upper arms. The patient did not have any major complaints on the third day and was tolerating orally well. It is shown that inflammation of the airways play a major role in the pathology of asthma and this starts when allergens or irritant trigger the activation of cells such as epithelial cells, macrophages, lymphocytes and mast cells. The West Oakland Middle School has 220 students enrolled and over 50 have been diagnosed with asthma and many more report undiagnosed respiratory concerns. Mild Asthma. Disclaimer: This work has been submitted by a student. NEW 2015!! Case study. These inflammatory symptoms are commonly associated with extensive but variable airflow obstruction within the lung as well as airway hyperresponsiveness and this is reversible either on its own or with treatment. 12th Feb 2020 Other preventer therapies may be included for the patient despite inhaled steroids being the first choice of drugs for preventer therapy. Any opinions, findings, conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of NursingAnswers.net. For diagnosed patients with asthma, acute exacerbations may occur and because patients with severe asthma are at increased risk of death following exacerbations, assessments of exacerbations are crucial. 1.) Some of the advice given in eczema management, for example allergen avoidance, will also be relevant in asthma management (Rees and Kanabar 2000). Further tests should be done to confirm this, and if it is diagnosed, she should be given ferrous supplements such as ferrous sulphate tablets 200mg twice daily. Moderate persistent. Preventing asthma-triggering events and practicing continuous maintenance therapies can significantly reduce the amount of disruption in a child’s life due to asthma symptoms. Examination on her lungs showed that she had prolonged expiratory phase. Although it is another option that may be added to daily controller medications for step 2 management, there is very little evidence on the clinical efficacy of it as a long term controller. Patient Profile C.S. Whereas in reality the reasons for non-compliance are complex (Holgate and Douglass 2006) and not necessarily the fault of the patient, for example, not being shown how to use their inhaler device properly (Carter et al 2005). Rolfe, Freshwater and Jasper (2001) suggest that choosing an event or incident to reflect upon or analyse is concerned with anything that happens to us that we want to write about for some reason. Generally, asthma is a chronic disease which follows the patient till the end of his life. It has also been seen that fluticasone and mometasone being administered at half the dosage of beclomethasone and budesonide shows equivalent clinical effectiveness, however there is somewhat inadequate evidence that fluticasone possesses fewer side effects and further studies need to be carried out on establishing the safety profile of mometasone.31 A new inhaled steroid has been introduced which is ciclesonide and clinical trials have shown evidence that it has more local activity than systemic and less oropharyngeal side effects as compared to the regular inhaled steroids.32-35 Although this seems promising, this clinical advantage is still controversial as its safety to efficacy ratio has yet to be established and compared with the conventional inhaled steroids. Having decided to focus on asthma as the topic for my case study, when I looked back at the patients I had seen with asthma, it was the above episode of care which held the most significance for me. Apart from that, monitoring of her condition was carried out consistently and all data was updated, leaving no room for questioning and doubt. Download file to see previous pages An asthma exacerbation can be caused by allergens (Sequeria & Steward, 2007). As further extensive studies need to be done to determine the most suitable route and dosing of magnesium sulphate, this treatment is reserved only for patients with acute severe asthma without satisfactory response to inhaled bronchodilator therapy and patients with life-threatening of near fatal asthma. Free resources to assist you with your nursing studies! Next, the patient’s updated blood cholesterol levels should be taken and the appropriate use of statins should be reviewed. A critical review of the key issues will follow using up to date evidence based literature and considering relevant policies. She was given all necessary treatment at point of admission and there was no lacking of medications in all four days of her hospital admission. Therefore, throughout neither my practice area nor the patient name will be identified. Registered office: Venture House, Cross Street, Arnold, Nottingham, Nottinghamshire, NG5 7PJ. Size: 74 KB. The material for the Pediatric Simulation and Unfolding Case Study is included in the document found in File 1. By day 4, the patient was comfortable, and her cough and sputum had decreased. Any opinions, findings, conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of NursingAnswers.net. Asthma . A 3-month-old child presents to the emergency room with her mother. 12+ Nursing Case Study Templates and Examples. Sinead, aged 10, is admitted with an exacerbation of asthma • Asthma is a chronic inflammatory disorder of the airways with reversible obstruction. She was also under nebulised combivent every 6 hours. share. Asthma . A single bolus dose of intravenous magnesium sulphate is administered to patients with acute severe asthma with previous unsatisfactory response to inhaled bronchodilator therapy or for patients who are suffering from life-threatening or near fatal asthma. ... Mrs T, who had suffered from asthma since the age of five years. Asthma is a worldwide problem as it is estimated that about 4.5% of the world’s population is affected, which amounts to 300million individuals approximately. Introduction The biological condition of asthma comes under the category of long-term pulmonary diseases. However even when concordance seems to have been achieved a patient still may not adhere to the agreed plan of care for many reasons (Weller and Booker 2006). for the medicines summarise basic social pharmacy issues (e.g. Her blood pressure (BP) was 152/82mmHg, pulse rate (PR) was 109 beats per minute (bpm) and was afebrile. Besides that, her other co-morbidities were also managed well as treatments for her hypertension and diabetes mellitus were given accordingly. Lastly, as she has low red blood count, haemoglobin and haematocrit levels, it is suspected that she has anaemia. Asthma: A descriptive case study. His parents state the difficult breathing ha The issues of education and concordance will be discussed together as they are inextricably interlinked. As she is on long-term statin use, her liver enzymes should be monitored regularly and if is raised by three-fold, she should stop taking the Lovastatin. Asthma has three distinguishing characteristics which are airflow limitation, airway hyperresponsiveness, and bronchial inflammation. PEWS TRAINING – CASE STUDY 1 . Alongside treatment of her acute condition, SK’s controller medications were reviewed and subsequent changes were made as appropriate. i am asked to concentrate on her respiratory problems relating to ineffective breathing pattern (IBP).i am having difficulty working out The goals of nursing … Cannot be used in conjunction with other promotional codes. Do you have a 2:1 degree or higher in nursing or healthcare? for the medicines summarise basic social pharmacy issues (e.g. The severity of the symptoms varies from person to person. The following shows the results that were out of the reference values for her haematological tests. This leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the morning. Each study shows that having a school nurse use case management has a positive impact on student attendance, and increase in quality of life with children who have asthma. I then intend to give a brief outline of the patient chosen for this study, explaining the reasons for that choice and the rationale behind the key issues highlighted for discussion. Student knowledge, attitudes, and skills are assessed using the rubric at the end of the assignment and during class discussion. ETIOLOGY Atopic asthma is triggered by environmental stimuli such as allergens (e.g. All work is written to order. These issues have been discussed and have shown to be interrelated; without achieving concordance, adherence to prescribed medication cannot be achieved and without patient education concordance cannot be realised. Do you have a 2:1 degree or higher in nursing or healthcare? Disclaimer: This work has been submitted by a student. He had asthma as a child. They are widely accepted as the ‘Gold Standard’ of evidence-based asthma care for health care professionals working in the UK (Levy and Pearce 2004). On Day 2 of her stay, her blood results came back and as she has low potassium levels, she was given 15mls of Mist KCl three times daily and two Slow K tablets once daily. The severity of the symptoms varies from person to person. She was then taken off the nebulizer combivent and the oxygen. There is nevertheless agreement on the fact that the numbers of cases of asthma are increasing. Referring to the case presented above, the patient was treated accordingly as she was immediately given supplemental oxygen and her SpO2 was maintained well above 96% throughout hospital stay. Steroids should always be given in all cases of acute asthma. Implications for Nursing Practice: Asthma occurs as a result of a stimulus which can range from allergens, cigarette smoke, changes in temperature, stress, or exercise. The term compliance in health care has become less fashionable recently due to it implying that a patient is perhaps ineffectual and hasn’t followed the health professionals’ instructions (Hyland 1998). The first care issue is to review the management of AEBA based on the British Guideline on the Management of Asthma. Copyright © 2003 - 2020 - NursingAnswers.net is a trading name of All Answers Ltd, a company registered in England and Wales. Watkins, Edwards and Gastrell (2003) agree, and suggest that currently the management of long-term conditions, including asthma, are a core component of a Advanced Nurse Practitioner’s work. They reinforce verbal education and set out for patients what to do if their symptoms worsen (Roberts 2002). ... Case Study Number One. Case Study: Patient With Shortness Of Breath ... she is currently on step 2 of the management of asthma. College. She stays in a factory area and has a cat at home. It not only reduces mortality but it also reduces relapses and the number of hospital admissions as well.19, 20 Oral steroids given are seen to be equally as effective as parenteral treatment hence there is no need for the use of parenteral administration of steroids unless the patient is unable to tolerate orally.19 Prednisolone 40-50mg is given daily for at least five days or until recovery and this can be stopped abruptly after the patient has recovered.2 As long as the patient is on inhaled steroids, there is no need for the dose to be tapered down slowly prior to discontinuation.21. Nursing Essay Stimuli such as irritants or allergens may pose as triggers in airway hyperresponsiveness and bronchial inflammation is associated with eosinophils, T-lymphocytes and mast cells which cause plasma exudation, smooth muscle hypertrophy, mucous plugging and epithelial changes.