NUM2306 Adult Health 1 Assessment 2: Case Study Essay

Aim of assessment
The purpose for this case study essay is to enable students to produce an assignment, using evidence-based information, to demonstrate their knowledge and understanding of asthma and the nursing care required of these patients. Content should include a discussion on the pathophysiology of the condition, analysis of the clinical manifestations, nursing management, assessment/investigations for asthma, treatment options based on national guidelines and implications for nursing practice.

Patient profile
Sonia Bates is a 19 year-old lady who lives at home with her parents. She is regularly active and swims every week. She has a history of asthma and is usually well controlled on her asthma medication. Sonia presented to the emergency department, complaining of shortness of breath and tightness in her chest.

Subjective data
• Was diagnosed with asthma at age 5 years
• Is taking daily salbutamol prn and seretide 125/25 via MDI 2 puffs twice a day.
• Has a non-productive cough and dyspnoea
• Appears distressed
• Able to speak in short phrases

Objective data

Physical examination
• Audible bilateral wheeze on expiration
• BP 110/60mmHg, HR 115 bpm, Temp 38.6 0Celsius, Resp 24 bpm, SaO2 93% RA, GCS 15
• Pulsus paradoxus palpable
• Visible use of accessory muscles
• Lung auscultation, decreased air entry both sides L=R

Diagnostic studies
• Peak flow 75% predicted value
• Chest Xray NAD
• ABG’s: pH 7.47, HCO3 23 mmol/L, PaCO2 35, PaO272

Your assignment is to produce a written piece of work addressing the following areas;

PATHOPHYSIOLOGY
• Briefly explain the pathophysiology of asthma in this patient. In your answer identify the clinical manifestations of asthma demonstrated by Sonia and why these are occurring.
MANAGEMENT
• Outline the immediate nursing and medical management Sonia requires in the treatment of this exacerbation of asthma. In your answer include the pharmacological management required by a patient with an acute exacerbation of asthma.
MEDICATIONS
• Identify three medications that would be used in the treatment of Sonia and outline the indication for use, mechanism of action, administration method, side effects, and nursing care required for these medications (No tables).

Important details about your assessment
• This essay requires a standard essay introduction and conclusion.
• There is a word limit of 1500 words (+/- 10% as per SNM Presentation and Assignment Guidelines).
• Marks will be allocated as per SNM Assessment Rubric & the essay specific criteria below.
• Submission instructions and the link is accessible under the ‘assessments’ tab.
• Students should refer to the SNM Presentation and Assignment Guide, ECU APA Referencing Guide, and the SNM Marking Assessment Rubric.
• Graphs, tables and flow charts to support the statistical data will not be accepted.