Reference no: EM132140487 , Length: word count:1250

Assignment -

Jackson Smith, a 18 year-old male, was admitted to the Emergency Department at 9pm with severe breathlessness. His family informed you that the patient has a history of Asthma that had been diagnosed when he was two years old. On admission to the Emergency Department the clinical manifestations were:

• Severe dyspnoea, inability to speak sentences in one breath
• Respiratory rate of 32 breaths/minute
• SpO2 90%, on room air
• BP 150/85 mmHg
• Pulse rate of 130 beats/minute
• Auscultation of lungs identifies diminished breath sounds and widespread wheeze

A chest x-ray was performed and showed a clear and hyper-inflated lung fields.

A blood gas was taken:

pH: 7.35

PaO2: 60mmHg

PaCO2: 50mmHg

HCO3: 25mEq/L

Lactate: 1

SaO2: 90%

A diagnosis of Acute Severe Asthma was made.

Question 1. (650 words) Explain the pathogenesis causing the clinical manifestations with which Jackson Smith presented with.

Question 2. (300 words) Discuss two high priority nursing strategies to manage Jackson and provide evidence-based rationales for these strategies.

Question 3. (300 words) Three of the drugs that were given to Jackson were continuous nebulised Salbutamol and nebulised Ipratropium bromide (4/24) and IV Hydrocortisone 100mg (6/24).

a. Discuss the mechanism of action of these drugs, and relate to the underlying pathogenesis of an Acute Severe Asthma. And,

b. Describe the nursing implications (monitoring for and responding to adverse effects, and evaluating therapeutic effect) when administering these drugs to a patient with an Acute Severe Asthma.

Tips for the guided questions -

Q1. identify the clinical manifestations Jackson has presented with (650 words)

• Discuss the pathogenesis for each of the clinical manifestations
• Relate your information back to the case study
• For help of what the clinical manifestations of ASA are check out the lecture for module 6. Then refer to case study
• Refer to the Australian Asthma Handbook

Q2. identify a high priority nursing strategies (300 words)

• While giving salbutamol is a high priority, I would encourage you to avoid discussing pharmacology in this question because you will be discussing this in Q. Think of other actions a nurse may need to do when looking after a patient who is hypoxic, tachypnoeic and tachycardic? Are you going to sitting him in a chair and let him wait 4 hours for the doctor to see him in the ED?

Q3. Discuss the drugs salbutamol, ipratropium & hydrocort. (300 words)

• This is fairly self-explanatory. But make sure you discuss them from a ASA perspective.

Attachment:- Assignment Files.rar