Question

Case study Alison is a 40-year-old single mother of two. Alison rarely drinks alcohol but has smoled 20 cigarettes a day since she was 16 years old. She is currently unemployed and lives in a smal council flat on the outskirts of town. She has recently found that she becomes increasingy breathless on exertion and when she woke up this morning she could not catch her breath A concerned friend took her to her local A&E. On arrival Alison was very distressed and found answering the nurse's questions very difficult as she could not complete a sentence without pausing for breath. The nurses takes a set of vital signed and a doctor takes an arterial byoo sample for gas analysis (see below). Alison is prescribed oxygen, salbutamol nebulizeo prednisolone orally. Over time Alison's condition stabilises and late with salbutamol and beclametasone inhalers. She is asked to return a few days later (pulmonary) function test. and r that day she is discharge fora ling

Answer 1

1. The physiological observations that are a cause of concern are distress and breathlessness on exertion. Her tests indicates increased heart rate, low oxygen saturation and low partial pressure of oxygen.

2. Arterial blood gas test measures the arterial partial pressure of oxygen, arterial partial pressure carbon dioxide, oxygen saturation, blood pH, bicaronate levels in blood. It is used in several pulmonary conditions. It helps determine the gas exchange across the alveolar-capillary membrane. The findings from ABG tests helps determine the severity of the pulmonary conditions and the doctors can decide the line of treatment based on the severity.

3. The patient is suffering from acute severe asthmatic attack. The pharmacological therapy includes:

- short acting B2 agonists like salbutamol

- anticholinergic medicines like ipratropium bromide

- inhaled corticosteroids

- long acting B2 agonists like salmeterol

- leukotriene receptor antagonist like montelukast and zafirlukast

- mast cell stabilizer like omalizumab

4. The risk factors are long history of cigratte smoking