Question

 Jennifer Hoffman Diagnosis: Acute asthma Location: Emergency Room

 Jennifer Hoffman is a 33-year-old female brought to Emergency Department by her neighbor.

 She has a history of asthma since childhood with multiple emergency visits within the last year. She appears to be in respiratory distress, struggling to breathe. She is unable to speak other than simple one-word statements.

 An infusion of normal saline has been started at a keep-open rate.

 Continuous ECG, SpO2 monitoring, and vital signs every 5 min

 Oxygen to maintain SpO2 greater than 92%

 IV normal saline at 150 mL/hour.

 Meds:

 Albuterol 5 mg in 3 mL normal saline via nebulizer every 20 minutes x 3 doses

 Ipratropium 500 mcg with first dose of albuterol

 Methylprednisolone 100 mg IV push

Answer 1

Management of patient with respiratory distress

* The nurse should assess the patient's respiratory status by monitoring breath sounds, pulse oximetery    and vital signs.

* Administer iv fluids to prevent dehydration and keep monitoring the rates.

* Assist the patient to be in upright position.

* Track asthma symption using a peak flow meter.

*Administer corticosteroids and rapid acting bronchodilators to clear the airways.

* Administer corticosteroids such as prednisone to reduce inflammation in airways with doctor's order.

* Administer humidified oxygen to prevent hypoxemia.

* Monitor the patient for the first 12 to 24 hours

   * Vital signs to be monitored.

   * Assess the patient's skin turgor for signs of dehydration