Question

D.R. is a 27-year-old man, who presents to the nurse practitioner at the Family Care Clinic complaining of increasing SOB, wheezing, fatigue, cough, stuffy nose, watery eyes, and postnasal drainage—all of which began four days ago. Three days ago, he began monitoring his peak flow rates several times a day. His peak flow rates have ranged from 65-70% of his regular baseline with nighttime symptoms for 3 nights on the last week and often have been at the lower limit of that range in the morning. Three days ago, he also began to self-treat with frequent albuterol nebulizer therapy. He reports that usually his albuterol inhaler provides him with relief from his asthma symptoms, but this is no longer enough treatment for this asthmatic episode.

According to the case study information, how would you classify the severity of D.R. asthma attack?
Name the most common triggers for asthma in any given patients and specify in your answer which ones you consider applied to D.R. on the case study.
Based on your knowledge and your research, please explain the factors that might be the etiology of D.R. being an asthmatic patient.

Answer 1

CLASSIFY SEVERITY OF ASTHMA

Components of severity	INTERMITTENT	PERSISTENT-MILD	PERSISTENT- MODERATE	PPERSISTENT-SEVERE
Impairment
Symptoms	less than or equal to 2days/week	greater than 2days/week, but not daily	daily	throughout the day
Nighttime awakenings	less than or equal to 2 times/month	3 to 4 times/month	greater than once/week, but not nightly	often 7 times/week

Short acting beta agonists use for symptom control	less than or equal to 2days/week	greater than 2 days/week, but not more than once/day	daily	several times/day
Interference with normal activity	None	minor limitation	some limitations	extremely limited.

Common Triggers for Asthma

• Tobacco smoke
• Dust mites
• Outdoor air pollution
• Cockroach allergen
• Pets
• Mold
• Smoke from burning woods or grass
• Other triggers like bad weather, physical exercise, certain medications, infections linked to influenza, colds etc

Mr. D.R who is a 27yrs old man, he might have triggering factors like exposure to dust mites, outdoor air pollution or pets.