Jackson Smith, a 18 year-old male, was admitted to the Emergency Department at 9pm with severe breathlessness. His family informed you that the patient has a history of Asthma that had been diagnosed when he was two years old. On admission to the Emergency Department the clinical manifestations were:
Severe dyspnoea, inability to speak sentences in one breath
– Respiratory rate of 32 breaths/minute
– SpO2 90%, on room air
– BP 150/85 mmHg – Pulse rate of 130 beats/minute.
– Auscultation of lungs identifies diminished breath sounds and widespread wheeze
A chest x-ray was performed and showed a clear and hyper-inflated lung fields.
A blood gas was taken: pH : 7.35
A diagnosis of Acute Severe Asthma was made.
ASSIGNMENT IS BASED ON ACUTE SEVERE ASTHMA NOT JUST ASTHMA
Question 1. (650 words) Explain the pathogenesis causing the clinical manifestations with which Jackson Smith presented with.
Question 2. (250 words) Discuss two high priority nursing strategies to manage Jackson and provide evidence-based rationales for these strategies.
Question 3. (300 words) Three of the drugs that were given to Jackson were continuous nebulised Salbutamol and nebulised Ipratropium bromide (4/24) and IV Hydrocortisone 100mg (6/24).
a. Discuss the mechanism of action of these drugs, and relate to the underlying pathogenesis of an Acute Severe Asthma. And,
b. Describe the nursing implications (monitoring for and responding to adverse effects, and evaluating therapeutic effect) when administering these drugs to a patient with an Acute Severe Asthma.
Responses are to use full sentences, paragraphs, correct spelling and grammar. – The word limit for the guided questions is 1200 words. Use your computer to total the number of words used. In-text citations will be included in the additional 10% of the word count. If you exceed the word limit by more than 10% the marker will stop marking. – Provide a reference list in APA 6th Edition style with a minimum of 6 academic references which could include journal articles, textbooks, government websites and reports, and creditable organisational websites (such as the Agency for Clinical Innovation (https://www.aci.health.nsw.gov.au/). – Appropriate resources must be selected and accurately used. The cited references must support your discussion or explanation. – Ensure that your concept map and guided questions are one document to upload through Turnitin.