Respiratory Therapy
Asthma Case Study
Initial History:
15 yo girl complaining of chest tightness and dyspnea
Mowing lawn when symptoms develop
Prodrome of rhinorrhea and tearing along with chest symptoms
Felt no better after going outside
Now one hour later
Additional information:
Hx of asthma since childhood, mother and brother have asthma
Allergic to grass, ragweed and cats
Productive cough clear phlegm
Uses a “blue” inhaler for past six months, BID
No other hx
Physical examination:
Alert, anxious, T=37, P=105, RR=30, BP=115/68, skin flushed and pink, diaphoretic, prolonged expository wheezes throughout all lung fields.
Lab results:
ABG (RA) pH 7.55, CO2 30, O2 65O2
Peak flow = 200 (less than 50% predicted)
WBC 5500
Repeat lab: (1 hour later)
ABG pH 7.35, CO2 43, O2 45 (40% VM) unable to perform peak flow
Patient does well with normal labs during hospital coarse. Discharged on the 5th day.
What steps can she take to prevent future attacks?
Steps to prevent future asthma attacks
Asthma cannot be cured but could be controlled and prevented. Stay away from the allergens like ragweed, cats, and grass that could trigger the attacks.
Develop a plan with your allergist for better control of the attacks by identifying the warning signs, the severity of attacks and how to handle the situation.
Exercises are found to be effective in controlling asthma to some extent. Find time to work out on daily basis.
Peak flow meter shows the movement of air through the lungs clearly. The narrowing of the airway that could happen in an attack can be identified beforehand through the peak flow meter, helping to take the medications to control the attacks.
Respiratory Therapy Asthma Case Study Initial History: 15 yo girl complaining of chest tightness and dyspnea...
Respiratory Therapy Asthma Case Study Initial History: 15 yo girl complaining of chest tightness and dyspnea Mowing lawn when symptoms develop Prodrome of rhinorrhea and tearing along with chest symptoms Felt no better after going outside Now one hour later Additional information: Hx of asthma since childhood, mother and brother have asthma Allergic to grass, ragweed and cats Productive cough clear phlegm Uses a “blue” inhaler for past six months, BID No other hx Physical examination: Alert, anxious, T=37, P=105,...
Respiratory Therapy Asthma Case Study Initial History: 15 yo girl complaining of chest tightness and dyspnea Mowing lawn when symptoms develop Prodrome of rhinorrhea and tearing along with chest symptoms Felt no better after going outside Now one hour later Additional information: Hx of asthma since childhood, mother and brother have asthma Allergic to grass, ragweed and cats Productive cough clear phlegm Uses a “blue” inhaler for past six months, BID No other hx Physical examination: Alert, anxious, T=37, P=105,...
Respiratory Therapy Asthma Case Study Initial History: 15 yo girl complaining of chest tightness and dyspnea Mowing lawn when symptoms develop Prodrome of rhinorrhea and tearing along with chest symptoms Felt no better after going outside Now one hour later Additional information: Hx of asthma since childhood, mother and brother have asthma Allergic to grass, ragweed and cats Productive cough clear phlegm Uses a “blue” inhaler for past six months, BID No other hx Physical examination: Alert, anxious, T=37, P=105,...
Respiratory Therapy Asthma Case Study Initial History: 15 yo girl complaining of chest tightness and dyspnea Mowing lawn when symptoms develop Prodrome of rhinorrhea and tearing along with chest symptoms Felt no better after going outside Now one hour later Additional information: Hx of asthma since childhood, mother and brother have asthma Allergic to grass, ragweed and cats Productive cough clear phlegm Uses a “blue” inhaler for past six months, BID No other hx Now what do you think about...
Initial History: 15 yo girl complaining of chest tightness and dyspnea Mowing lawn when symptoms develop Prodrome of rhinorrhea and tearing along with chest symptoms Felt no better after going outside Now one hour later Additional information: Hx of asthma since childhood, mother and brother have asthma Allergic to grass, ragweed and cats Productive cough clear phlegm Uses a “blue” inhaler for past six months, BID No other hx Physical examination: Alert, anxious, T=37, P=105, RR=30, BP=115/68, skin flushed and...
Initial History: 15 yo girl complaining of chest tightness and dyspnea Mowing lawn when symptoms develop Prodrome of rhinorrhea and tearing along with chest symptoms Felt no better after going outside Now one hour later Additional information: Hx of asthma since childhood, mother and brother have asthma Allergic to grass, ragweed and cats Productive cough clear phlegm Uses a “blue” inhaler for past six months, BID No other hx Physical examination: Alert, anxious, T=37, P=105, RR=30, BP=115/68, skin flushed and...
Respiratory Therapy Asthma Case Study Initial History: 15 yo girl complaining of chest tightness and dyspnea Mowing lawn when symptoms develop Prodrome of rhinorrhea and tearing along with chest symptoms Felt no better after going outside Now one hour later What is the differential diagnosis based on the information you know?
Respiratory Therapy Asthma Case Study Initial History: 15 yo girl complaining of chest tightness and dyspnea Mowing lawn when symptoms develop Prodrome of rhinorrhea and tearing along with chest symptoms Felt no better after going outside Now one hour later What other questions would you ask?
A 19-year-old female college student presents to the emergency department complaining of chest tightness and dyspnea. She was cutting and trimming the lawn when these symptoms developed. Rhinorrhea and tearing began soon after she went outside and preceded the chest discomfort. Going inside did not relieve her symptoms. During the physical examination, she said, “I have had asthma since childhood, and my mother and brother also have asthma.” Her respiratory rate was 30 breaths per minute, and she exhibited the...
CASE STUDY A 19-year-old female college student presents to the emergency department complaining of chest tightness and dyspnea. She was cutting and trimming the lawn when these symptoms developed. Rhinorrhea and tearing began soon after she went outside and preceded the chest discomfort. Going inside did not relieve her symptoms. During the physical examination, she said, "I have had asthma since childhood, and my mother and brother also have asthma." Her respiratory rate was 30 breaths per minute, and she...