TICAL THINKING CASE STUDY MA, a 55-year-old pat chial asthma. old patient, was r
ID: 240647 • Letter: T
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TICAL THINKING CASE STUDY MA, a 55-year-old pat chial asthma. old patient, was recently diagnosed with bron- To minimize the frequency of MAs asthmatic attacks, the health r mother and three brothers also have asthma. care provider prescribes aminophylline 1200 mg/day ear, MA has had three asthmatic attacks that were doses. The albuterol inhalation is to be taken as needed. Nursing In the with prednisone and an albuterol inhaler. At an office interventions include patient history of asthmatic attacks and it toda prednisone is prescribed for 4 weeks, and the order physical assessment. is writen as follows: day 1, I tablet 4 times a day; day 2,.I tablet 5. When taking the patients history, what should the nurse 3 times a day; day 3, 1 tablet 2 times a day; day 4, 1 tablet in the include concerning asthmatic attacks? What physical assess- morning day 5, one-half tablet in the morning 1. Explain the purpose for the use of prednisone during an asth- 6. What type of drug is aminophylline? Why should the nurse matic attack. Explain why the dosage is decreased (tapered) ask MA if she smokes? over a period of 5 days. ment would suggest an asthmatic attack? 7. What are the side effects, adverse reactions, and drug inter- 8. What nonpharmacologic measures can the nurse suggest 9. Which are appropriate rescue medications used for acute 4. For each drug dose, MA is to take two puffs of albuterol asthmatic attacks? Which drugs are used as preventive 2. Can cromolyn sodium be substituted for prednisone during actions related to aminophylline? an asthmatic attack? Explain your answer 3. MA is prescribed albuterol. What effect does albuterol have that may decrease the frequency of asthmatic attacks? on controlling asthma? administered by the inhaler. What instructions should she be given concerning use of the inhaler? medications?Explanation / Answer
1.Prednisolone will reduce inflammation ,swelling and clear the airway passage.As a steroid it gives its immediate action and relieve the breathing difficulty.
Cortisol is the natural steroid produced in our body.It has an action of anti-inflammation.we use prednisolone in acute conditions then it is gradually decreased because then only the cortisol in the body gets increase or else the body become depend on external steroid.
2.No cromolyn sodium cannot be used during an attack,it just prevent the inflammatory action but not relieve the inflammation at the acute conditions.
3.Albuterol is the beta2- adrenergic agonists which is a bronchodilater.
4.While using the inhaler the patient first remove the external cap.shake it well.If it is used since long days then puff out at least 4 puffs in air . Then hold the mouth piece tightly by the mouth then breath in and give the first puff.wait for one minute again give the second puff.Cover the mouth piece by external cover.
5. use of accessory muscles,presence of central cyanosis,wheeze,dysnea and chest tightness.
6.Aminophylline is the combination of theophylline and ethylenediamine.It is a xanthines class of drug.The substance in the smoking will reduce the theophylline action hence more dose then it results in toxicity.To monitor the drug level in serum is important to ask about smoking.
7.Side effects are allergic reactions in skin,chest discomfort,abdominal pain,dizziness, nausea, vomiting,muscle cramps, muscle stiffness.
Serious adverse reactions are seizure,hypotension,shock,exfoliative dermatitis and arrhythmias.
It interact with drugs such as cimetidine,carbamazepine,quinolones and many other.
8.A practice of yoga is one of the measure for asthma.Breathing exercise,forced inhale and exhale technique,alternate nostril breathing,breathing relaxation. These exercises provide enough amount of oxygen,strengths the muscles and clear the airways.
9.Rescue medication is prednisolone.
Preventive medication is cromolyn sodium.
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