Reference no: EM133005641

NURS90125 Nursing Science

Case Study One:

Aamira (She/her) 6-year Sudanese-Australian girl who was admitted to the ward last night with an infective exacerbation of atopic asthma. Aamira was brought by her parents to the Emergency Department (ED) yesterday with reports of pain in the chest, dry cough, fever (39.1 °C), profuse sweating and lethargy. In the ED, she has been prescribed salbutamol 4- 12 inhalations (400-1200 micrograms) via spacer or nebulise 5 mg and spirometry has been ordered. SpO2 improve with 2 litres of oxygen (28% FiO2) via nasal cannula. Blood and urine samples were collected prior to commencement of intravenous (IV) fluid therapy and IV ceftriaxone [50 mg/kg (maximum 2 g) once daily]. Aamira's's regular medications include Symbicort [budesonide (200 mcg/dose) and eformoterol (6mcg/dose) inhaled twice daily. In the emergency department (ED), Aamira's vital signs were:

• SpO2 94%

• Respiratory rate 32 breaths per minute

• Widespread expiratory wheeze

• Heart rate 98 beats per minute (regular)

• Temperature 39.1ºC

• Blood pressure 106/62 mmHg.

a) Explain the pathophysiological changes of asthma in Aamira's case in relation to her current symptoms (Maximum 250 words)

b) Explain how Symbicort exerts its effects and how this will assist in relieving Aamira's symptoms. (Maximum 150 words)

c) Identify 5 possible complications of Symbicort that should be considered in planning her nursing care whilst she is in hospital (Maximum 100 words)

Case study 2

Mr. Sergio Ramos (He/him)is a 57-year-old bus driver with a history of primary hypertension and Hyperlipidaemia. He presents to the Emergency Department via ambulance with repeated emesis over the last four (4) hours, slurred speech and right sided hemiplegia. Sergio is overweight and his family history of atherosclerotic disease. His current medications are as follows: Karvezide [irbesartan (150 mg per day) and hydrochlorothiazide (12.5 mg per day),] and Vytorin [simvastatin (20mg daily?) and ezetimibe (10 mg), once daily]. Dr. Smith suspects a left middle cerebral artery embolic stroke and organises a CT scan.

a) Discuss each of Sergio's presenting signs and symptoms by explaining the pathophysiological changes with each following his left middle cerebral artery embolism? (Maximum 250 words)

b) Explain what is meant by the "ischemic penumbra" and how early recognition and treatment of stroke can improve patient outcomes significantly. (Maximum 150 words)

c) Outline the medical management of embolic stroke in patients presenting less than 5 hours from the of onset of symptoms. (Maximum 100 words)

Attachment:- Nursing_Science.rar