Question

CASE STUDY SCENARIO Tony is an 11-year-old boy who has come to a local walk-in clinic with his mother. He is having difficulty breathing with audible high-pitched wheezing. During the nursing assessment you observe that he becomes quickly fatigued and very short of breath while answering your questions. His mother reports that Tony was at the petting zoo that morning on a school retreat and since has developed worsening asthma symptoms. Before coming to the clinic, Tony used his Flovent (fluticasone) puffer but the symptoms did not alleviate. His mother tells the nurse that Tony has a blue puffer as well as the orange Flovent puffer but has not used the blue puffer today. While auscultating Tony's lungs, the nurse hears expiratory wheezes throughout and decreased breath sounds into the bases. His vital signs are as follows: blood pressure 110/82; pulse 116; respiratory rate 39; oxygen saturation on room air is 88 % Tony is started on a Beta-adrenergic Agonist (B2-Agonist), salbutamol (Ventolin) nebulizer and 1ol of Oxygen via face mask PART 1: Questions Briefly describe asthma in a way that Tony and his mother would understand. Wwhat 1. pathophysiology is occurring which makes it difficult for Tony to breathe? What are some of the questions that you might ask Tony and his mother, when gathering 2.

Answer 1

CASE STUDY SCENARIO Tony is an 11-year-old boy who has come to a local walk clinic with his mother. He is having difficulty During the nursing assessment you observe that he breathing with audible high-pitched whe becomes quickly fatigued and very short of breath while answering your questions. His mother reports that Tony was at the petting zoo that moni asthma symptoms. Before coming to the clinic, Tony used his Flovent (fluticasone) puffer but the symptoms did not alleviate. His mother tells the Flovent puffer but has not used the blue puffer today. g on a school retreat and since has developed worsening What are some of the questions that you might ask Tony and his mother, when gathering 2. that Tony has a blue puffer as well as the orange During the assessment of an asthma patient, it is important to identify the While auscultating Tony's lungs, the nurse hears expiratory wheezes throughout and decreased breath sounds into the bases. His vital signs are as follows: blood pressure 110/82; pulse 116; respiratory rate allergens triggering asthma. The two general categories of asthma are 1. Extrinsic asthma or allergic asthma Occurs in response to dust, pollen, or other irritants (allergy). It is common in children 2. Intrinsic or non-allergenic asthma - Occurs in response to emotion, strong odors or fumes, viral infections, medications and others. It is common in adults. 39, oxygen saturation on room air is 88%. O Tony is started on a Beta-adrenergic Agonist (B2-Agonist), salbutamol (Ventolin) nebulizer and 1ol of oxygen via face mask. So, the physician should ask Tony and his mother about the history of events PART 1: Questions associated with the asthma events. In the given case, Tony's symptom became worsen after been to the zoo park. So, the animal pollen might be the trigger. Briefly describe asthma in a way that Tony and his mother would understand. What pathophysiology is occurring which makes it difficult for Tony to breathe? 1. Asthma is a chronic inflammatory disease of the airways. The patient suffers from difficulty in breathing (dyspnea) due to the bronchoconstriction and accumulation of mucus (causes wheezing), chronic dry cough, tightness in the chest and bronchospasm. Pathophysiology of asthma:Asthma occurs due to persistent subacute inflammation of the airways. The clinical features and physiology of the asthma is due to interaction of the infiltrating and resident inflammatory cells, inflammatory mediators and cytokines with the airway surface epithelium. Due to the inhalation of the allergens or due to huminal stimuli, Inflammatory mediators (endothelin-1, PGE2, 15-HETE), Cytokines (GM-CSF, IL-8, RANTES) and growth factors (EGF, IGF-1, PDGF) are released. Endothelin-1 causes bronchoconstriction. PGE2, PG12, 15-HETE results in vasodilation. Cytokines causes inflammation and growth factors causes fibrosis and smooth muscle hyperplasia.