Question

A.N is a 28-year-old male who presents to the clinic with complaints of having episodes of dyspnea, coughing & chest feeling tight. A.N states it started after he got over his cold a few weeks ago.

1. As the R.N, explain what additional data you would obtain. (USLO 1, 2)

Here is the additional data that you obtained. V.S- 125/78, 78, 22, 98.4, O2 sat 93%. No apparent respiratory distress currently. Bilateral wheezes heard in lower lobes. Symptoms do seem to occur while he is exercising and sometimes cause him to stop exercising. A.N has a history of allergies but has not been treated for allergies in years. Does have a positive family history of asthma (maternal grandmother). Pulmonary function tests reveal a diagnosis of asthma. The provider prescribes montelukast (leukotriene modifier), five days of prednisone, and an albuterol inhaler as his rescue inhaler.

2. Explain the rationale for the medications that were prescribed. (USLO 3)

3. Explain the purpose of peak flow meter and what role it plays in self-management of asthma. What education do you provide to A.N regarding his peak flow meter value? What does he do if his peak flow value falls into the red zone? (USLO 1, 6)

4. A.N asks two questions- Do I take the montelukast even when I don’t have any symptoms? How will I know when I need to take my albuterol inhaler? How would you respond? (ULSO 2, 3, 5)

5. Describe status asthmaticus. What symptoms would you expect the patient to experience? What assessment finding would indicate an emergency? (USLO 1, 2, 6)

Answer 1

1, As the RN we have to check patient vital signs, o2 saturation in case of breathing disorder. collect patient history and make a physical examination to reveal the symptoms.
2, Montelukast prevents wheezing and shortness of breath that is caused by asthma it reduces the number of asthma attacks. it also avoids breathing problems during exercise.
3, when asthma worsens the airway narrows. the peak flow meter measures the peak expiratory flow rate that measures the open lung airway. it decreases in asthma. monitoring peak flow daily as an asthma home treatment that identifies the asthma symptoms severity and treatment effectiveness.
educate the patient to monitor regularly even though the symptoms are better or absent. The peak flow meter should be in zero when not in use.
Use peak flow meter when standing straight and take a deep breath and place the peak-flow meter in mouth and tongue under the mouthpiece, don't close the mouthpiece with the tongue. close your mouth tightly with a mouthpiece. blowhard as much as possible then breathe normally and do it again for two more times. Note down the highest number recorded.
If peak flow rate less than 50% that is red zone indicates need medical emergency, use bronchodilator or other prescribed medicine to clear and open the airway and consult the doctor.
4, Don't stop the medication if symptoms are absent or less. unless the doctor orders never stop the medication, if you stop the medication in between it will increase your asthma symptoms and cause lung damage.
Albuterol stops the bronchospasm, take two puff every 4to 6 hours and take albuterol inhaler 2puffs 15 to 30 minutes before exercise.