Question

Case study evaluation of the pathophysiologic alterations that affect the neurologic and respiratory systems.

Case study: 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

Focus:

Investigate the pathophysiology of asthma and the clinical 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 (etiology) J.S. to have an exacerbation of asthma.
3. Outline the causes of asthma, the symptoms that the client presents and the management of the disorder.

(References are greatly appreciated if possible.)

Answer 1

Asthma

It is a chronic condition that affects the airways. It results in wheezing and can make it hard to breathe .

pathophysiology of asthma

inflamed airways react to environmental triggers like

• Dust
• Pollen
• Smoke
• Environmental pollutants
• Some toxic chemicals

clinical manifestations

• severe or dry cough
• Difficulty in breathing
• Wheezing
• Fast breathing
• Rapid breathing
• Shortness of breath
• Chest pressure
• Anxiety

what symptoms support the diagnosis of asthma

• Dust and pollen allergies
• History of mild asthma
• unable to lie down
• use of accessory muscles to breath
• Anxious
• Short of breath

Identify the treatment provided in the emergency department

• Oxigen support on 4 litters
• intravenous (IV) D5W at 75 mL/hr

determinetermine what additional therapies are needed to mitigate the asthma symptoms and return the client to wellness.

• Learning to identify triggers
• Recognise the triggers
• Avoid triggers
• Track of breathing

concerns with the numbers

BP = 152/84 , considerably high blood pressure.

HR = 124bpm is high

RR = 42 is high

Temp = 100.40F it is high

pH = 7.31 acidosis

PaCO2 = 48 ,respiratory acidosis

HCO3 = 26 normal

PaO2 = 55 , not getting enough oxygen