Question

PN 200 Fundamentals of Nursing II Case Study: Bronchial Asthma Michael Allen, a 35-year-old patient, was recently diagnosed with bronchial asthma. His mother and three brothers also have asthma. In the past year, Michael has had three asthma attacks that were treated with prednisone and albuterol (Proventil) inhaler. At the office visit today, prednisone is prescribed for 4 weeks, and the order is written as follows: Day 1 I tablet by mouth four times a day Day 2 Day 3 Day 4 Day 5 I tablet by mouth three times a day 1 tablet by mouth two times a day 1 tablet by mouth in the morning tablet by mouth in the morning 1. Explain the use of prednisone during an asthma attack. Explain why the dosage is decreased (tapered) over a period of 5 days. 2. Can Cromolyn sodium (NasalCrom) be substituted for prednisone during an asthma attack? Explain your answer. 3. Michael is prescribed albuterol (Proventil, Ventolin). What effect does albuterol have controlling asthma? 4. For each drug dose, Michael is to take two puffs of albuterol administered by an in What instructions should be given to the patient concerning the use of an inhaler? To minimize the frequency of Michael's asthma attacks, the health care provider prescrit theophylline (Elixophyllin) 200 mg. twice a day. The albuterol inhaler is to be taken as Nursing interventions include patient history of asthma attacks and physical assessment. 5. When taking the patient's history, what should the nurse include concerning ast attacks? . 111 1

Answer 1

1. Tab Prednisone (Per Oral ) is indicated in acute asthma. It helps reduce the inflammation in the airways in people who are experiencing an asthma attack and also very effective at reducing the recurrence of acute asthma symptoms following a visit to the emergency room or hospital.  Prednisone is a corticosteroid and the sudden withdrawal of Prednisone can cause extreme fatigue, weakness, stomach upset, or dizziness; it also can be life-threatening, so, it is an accepted practice to reduce the dosage of the drug instead of stopping it abruptly on one day/time.

2.

Cromolyn sodium is a  mast cell stabilizer and is available as a nebulizer solution. It prevents asthma symptoms, especially in children with allergies and asthma and in people with exercise-induced asthma, Cromolyn can be taken 30 minutes before the activity to prevent symptoms. Cromolyn sodium is very safe and has few if any, side effects. It cannot be used as a substitute for Prednisone as it's role is in prevention rather than management and it is not useful in reducing airway inflammation.

3. Albuterol is an inhaled medication classified as a bronchodilator and a short-acting or quick-relief medication. It works in the airways by opening breathing passages and relaxing muscles

4. Michele should be taught about the proper way of using an inhaler. Michael shall be instructed as follows. You should prime your inhaler the first time when you use or as per manufacturer's instruction. You should .shake the inhaler well before each spray. Take the cap off the mouthpiece of the actuator and hold the inhaler with the upside-down or mouthpiece facing down. Then exhale through your mouth and push as much air from your lungs as you can. Followed by this putt the mouthpiece in your mouth and close your lips around it. Push the top of the canister all the way down while you breathe in deeply and slowly through your mouth. Right after the spray comes out, take your finger off the canister. After you’ve breathed in all the way, take the inhaler out of your mouth and close your mouth. Hold your breath for as long as you can, up to 10 seconds, and then breathe normally. Wait 1 minute, shake, and use it again one more time(total 2 puffs). Put the cap back on the mouthpiece after every time you use the inhaler. Make sure the cap is closed properly. Clean your inhaler after use. If any reactions(fast heartbeat or irregular heartbeats) happen please inform your doctor or nurse and stop taking Albuterol until the physician says so.