Question

• 23-year-old male admitted for asthma exacerbation.
  • Vital signs: Temp 98.9 F, BP 121/82, HR 99, RR 28, SPO2 91%
  • Assessment: Alert and oriented x4, Cardiac WNL except tachycardia, Respiratory: Wheezing in bilateral lower lobes, dyspnea, GI WNL, GU deferred
  • Orders: Vital signs Q2H and PRN, Albuterol 2 puffs Q4H PRN, Solumedrol 125 mg IV Q12H
  • Problem: Patient is having difficulty breathing even after being given Albuterol (bronchodilator) and Solumedrol (steroid).
• What is your recommendation? (ISBAR)

Answer 1

The recommendation for this patient are

• To start with long anticholinegic bronchodilator inhaler along with albuterol (it prevents spasm and dilates the bronchial tube and enhance breathing)
• Use of spacer in inhaler
• Intravenous magnesium sulphate (reduces spasm and swelling and this improves the functions of lungs )
• Continuous beta 2 agonist administration