Question

In: Nursing

A 15-year-old white female with a history of asthma since early childhood.

 

A 15-year-old white female with a history of asthma since early childhood.

He diagnosis with asthma and Contraception initiation

Question

1. Diagnosis asthma

a. Explain the Pathophysiology of asthma

b. What is the therapeutic regimen of asthma?

c. What labs can you order for this patient?give the definition and Description of the Test. At least 2 labs

d. Significance of the Test Being Ordered for this Patient

E. What medication would give to this patient et why?

 

Solutions

Expert Solution

a)Pathogenesis of asthma. (A) Sensitization: Inhaled allergens (antigen) are taken up by antigen presenting cells (macrophage/ dendritic cell) and shows a TH2-dominated response favoring IgE production and eosinophil release.

(B) On re-exposure to antigen (allergen), they bind to IgE bound on mast cells and release preformed mediators from mast cells. These mediators, either directly or via vagal stimulation produce bronchospasm, increased vascular permeability, and mucus production.

(C) The recruitment of leukocytes (neutrophils, eosinophils, and basophils; lymphocytes and monocytes) signals the beginning of the late phase and a fresh round of mediator released from leukocytes, endothelium, and epithelial cells. Major basic protein, eosinophil cationic protein also causes damage to the epithelium.

b)For mild episodic asthma:Inhaled short acting beta 2 agonist at onset of each episode.

For seasonal asthma:regular low dose inhaled steroid(200-400 microgram/day) or cromoglycate given 3-4 weeks before the season until 3 weeks after the season.And for individual episodes we can give beta 2 agonist.

For mild chronic asthma with occasional exacerbations: regular low dose steroid ( 100-500 microgram/day).Alternatively give cromoglycate or oral theophylline inhalation.episode treatment by inhaled beta 2 agonist.

For moderate asthma with frequent exacerbations: Increasing doses of inhaled steroid (upto 800 micrograms/day) + inhaled beta 2 agonist. Leukotriene antagonists can be tried instead of beta 2 agonist.

For severe asthma:i) Regular high dose inhaled steroid (800-2000 microgram/day) through a large volume spacer device + inhaled long acting beta 2 agonist(salmeterol) twice daily.

ii)For refractory asthma: Hydrocortisone hemisuccinate 100 mg.i.v.stat followed by 100-200 mg 2-4 hourly infusion.

iii)Nebulized salbutamol(2.5-5 mg) + ipratropium bromide(0.5 mg) intermittent inhalations along with oxygen.

iv)High flow humidified oxygen inhalation

v)Salbutamol/terbutaline 0.4 mg im/sc may be also added.

C) i)Lung Function test: These are group of tests that measures how well your lung works, how well the lungs take in and exhale air and how efficiently they transfer oxygen into blood.It is based on measurement of volume of air breathed in and out in normal and forced respiration. It is done using spirometer.

ii)Sputum test: This is done on saliva and mucus discharged on coughing. We look for the eosinophils which becomes visible when the symptoms appear using a rose stain.

d)As she is someone who has asthmatic problems from childhood it can be due to some abnormality in her lung functioning so lung function test can be done.Sputum test is done to check if it is some kind of excercise or cold induced asthma.

e)As the asthma is controllable and not much severe it comes under mild episodic asthma ,so the most suitable medication would be: inhaled short acting beta 2 agonist on the onset of each episode.


Related Solutions

A 15-year-old white female with a history of asthma since early childhood.
  A 15-year-old white female with a history of asthma since early childhood. He diagnosis with asthma and Contraception initiation Question 1. Diagnosis asthma a. Explain the Pathophysiology of asthma b. What is the therapeutic regimen of asthma? c. What labs can you order for this patient?give the definition and Description of the Test. At least 2 labs d. Significance of the Test Being Ordered for this Patient E. What medication would give to this patient et why? 2. Diagnosis:...
Kiara is a 53-year-old female with severe chronic persistent asthma. She also has a history of...
Kiara is a 53-year-old female with severe chronic persistent asthma. She also has a history of osteoporosis, diabetes, and hypertension. Her daily treatment regimen for the control of her asthma is comprised of high-dose inhaled beclomethasone, inhaled salmeterol, slow-release theophylline, and monteleukast. She has complained to her specialist that she is still having frequent exacerbations and night-time symptoms. He then decides to put her on a short course of oral prednisone for 14 days. a. How would prescribing additional glucocorticosteriods...
A 34-year-old male certified public accountant, has struggled with being overweight since early childhood.
A 34-year-old male certified public accountant, has struggled with being overweight since early childhood. His current anthropometric measurements are: 6’1”, 427 pounds. After months of careful consideration, the patient and his physician have decided that gastric bypass surgery is the best option to help him prevent the development of adult-onset diabetes and manage his high blood pressure and hyperlipidemia.Calculate the patient’s ideal body weight and current BMI.What will be the dietary progression for the patient after his surgery?List at least...
M.T. is a 58-year-old white female with a history of chronic myelogenous leukemia (CML). She is...
M.T. is a 58-year-old white female with a history of chronic myelogenous leukemia (CML). She is receiving maintenance therapy with hydroxyurea, with a history of prior treatment with imatinib mesylate. She was recently visiting her sister for several days who has a new grandchild in the home. During her visit, she appeared to develop a viral infection, with a low grade fever and cough. Presently, she is experiencing malaise and reports both her feet have been feeling cold throughout the...
History: Tracy Moore, a 29-year-old white female, was transported by ambulance to the emergency room after...
History: Tracy Moore, a 29-year-old white female, was transported by ambulance to the emergency room after being rescued from her burning house. She was asleep at night when a spark from the family fireplace started a fire, leaving her trapped in her bedroom. By the time the fire rescue squad arrived, she had suffered severe burns. Vitals at the scene were as follows: HR = 110, BP = 150/90; R = 22, Temperature 100.1, SPO2 = 96% on Room Air....
Case study: Miranda Miles is a 35-year-old white female. She has a 10-year history of cigarette...
Case study: Miranda Miles is a 35-year-old white female. She has a 10-year history of cigarette smoking and refuses to quit after several educational teachings from health care providers and family members. There is no history of alcohol consumption. She has been married for five years and lives with her husband and son. Miranda works at a factory and her husband is a truck driver. She was admitted on August 7th, 2020 at 1700 with complaints of joint and back...
A 40-year-old man who has been separated from his father since early childhood tells the nurse...
A 40-year-old man who has been separated from his father since early childhood tells the nurse that his father recently contacted him to inform him that he is dying of Huntington disease. What is an essential component of care for this patient? A Assist the patient in determining signs of neuromuscular weakness B Instruct the man on treatment options for Huntington disease C Teach the man how to avoid passing Huntington disease to his own children D Provide genetic counseling,...
Assessment: Chief Complaint: 72-year-old woman who fell on her right hip. History: 72-year-old white female, was...
Assessment: Chief Complaint: 72-year-old woman who fell on her right hip. History: 72-year-old white female, was brought to the Emergency Room after falling. She was previously in good health, despite leading a relatively sedentary lifestyle and having a 30-year history of cigarette smoking. The only medication she currently takes is propranolol for mild hypertension. She fell upon entering the bathtub when her right leg slipped out from under her; she landed on her right hip. There was no trauma to...
History: Margaret Donovan, a 72-year-old white female, was brought to the emergency room by her son-in-law...
History: Margaret Donovan, a 72-year-old white female, was brought to the emergency room by her son-in-law after falling in her bathtub. She was previously in good health, despite leading a relatively sedentary lifestyle and having a 30-pack-year history of cigarette smoking. The only medication she currently takes is Inderal (propranolol) for mild hypertension. She fell upon entering the bathtub when her right leg slipped out from under her; she landed on her right hip. There was no trauma to her...
A 27-year old white female presented her self at her local physician on August 15. On...
A 27-year old white female presented her self at her local physician on August 15. On physical exam, the patient had a fever of 38.5C. She appeared fatigued, had tender abdomen and complained of headache, stiff neck and backache with diarrhea. The physician noted an irregular heartbeat. The patient complained of lack of ability to concentrate. The patient gave the following history: She is a graduate student in the wildlife program at the University in her town. She was in...
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT