Question

J.S. is a 42-year-old man who lives in the Midwest and is highly allergic to dust and pollen and has a history of mild asthma. J.S’s wife drove him to the emergency room when his wheezing was unresponsive to his fluticasone/salmeterol (Advair) inhaler. J.S. was unable to lie down, and began to use accessory muscles to breathe. J.S. is immediately started on 4 L oxygen by nasal cannula and intravenous (IV) D5W at 75 mL/hr. A set of arterial blood gases is sent to the laboratory. J.S. appears anxious and says that he is short of breath.

Vital signs

BP = 152/84            HR = 124 bpm                   RR = 42        Temp = 100.40F
ABGs
pH = 7.31               PaCO2 = 48             HCO3 = 26    PaO2 = 55

Investigate the condition of asthma and the manifestations of the disease. Analyze the case study provided and determine what symptoms support the diagnosis of asthma. Identify the treatment provided in the emergency department and determine what additional therapies are needed to mitigate the asthma symptoms and return the client to wellness.

1. Do you have any concerns with the numbers above?
2. Identify what may be causing J.S. to have an exacerbation of asthma.

Prepare a 3-5 page paper outlining the causes of asthma, the symptoms that the client presents and the management of the disorder.

3 pages please no less. I need 3 pages

Answer 1

ASTHMA

Asthma is a chronic inflammatory disorder of the airways. The chronic inflammation causes increase in hyperresponsiveness.

TRIGGERS OF ASTHMA

Allergents:most of the cases are due to allergic response .It is seasonal and related to pollen. Non seasonal forms of asthma may be related to dust mites, molds, animal feathers.

Exercise :it also trigger asthma attack. Typically exercise induced asthma occurs after vigorous exercise.

Air pollutant :Air pollutant such as cigarette or wood smoke, vehicle exhaust, silver dioxide and nitrogen dioxide can trigger asthma attack.

Occupational factors:In occupational places, the triggers includewood and vegetable dust, pharmaceutical agent, animal and insect dust.

Respiratory infections:mostly viral infection (influenza and rhinoviruses) .

Nose and sinus problems :allergic rhinitis,nasal polyp.

drugs and food additives:drugs such as aspirin and NSAIDs, dye like tartrazine and suffering agent triggers asthma attack .

Gastrointestinal esophageal reflex disease :the contents can be aspirated into the lungs cause reflex bagel stimulation and bronchoconstriction.

Psychological factors :psychologic or emotional stress may triggers the asthma attack.

CLINICAL MANIFESTATION

:wheezing

:breathlessness

:chest tightness

:cough

:inspiratory-expiratory ratio is 1:3 or 1:4

:signs of hypoxemia-, restlessness, anxiety, inappropriate behavior ,pulses paradoxes, Lawrence pressure, increased respiratory rate, and use of accessory muscle for respiration.

DIAGNOSTIC STUDIEs

History collection and physical examination

chest X-ray

ABG analysis

allergy skin testing

blood level of eosinophil

nitric oxide level

pulmonary function test

TREATMENTSINCLUDE:

care s focused on correcting hypoxemia and improve ventilation

:nebulization with beta-2 adrenergic agonise, usually albuterol hourly.

:IV magnesium sulfate

:administration of corticosteroids

:if severe may need intubation and mechanical ventilation .

from the above case the investigation support the diagnosis is, patient have wheezing ,use of accessory muscle for respiration ,increased respiratory rate ,and ABG  show decrease in pao₂ and increase in paco_2.

_{:causes of exacerbation of asthma of Mr. cJ is exposure to allergent like dust and pollen.}

_{Additional treatment for Mr. CJ include}

_{:IV magnesium sulfate}

_{:IV corticosteroid}

_{:Beta-2adrenergic against inhalation}

_{if condition is severe, incubation and mechanical ventilation .}