Question

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 use of accessory muscles of respiration. Breath sounds

were decreased, except for expiratory wheezes. Heart sounds were distant with

tachycardia, but regular.

Identify appropriate laboratory tests. Indicate what therapies might be initiated. What worsening signs and symptoms may manifest?

Answer 1

The laboratory test which will be included for the patient are

• Complete blood count:to rule out infection (increased WBC), to know allergy (increased eosinophil)
• Spirometry or pulmonary function test
• Chest X ray
• An ABG to rike out the level of oxygen in the blood

The therapies which will be initiated are

• Antihistamine to stop allergic reactions
• Bronchodilators ( nebulisation) to relieve wheezing, shortness of breath
• Corticosteroid ti reduce any inflammation of the airway
• Antibiotics are prescribed in case 9f any infection

The worsening signs and symptoms which may manifest are

• Hypoxia
• Cyanosis
• Loss of consciousness
• The use of bronchodilators ,inhalers frequently is a worsening sign
• Decrease in respiratory rate,saturation level is a very worsening symptom