Case study Mr James Saunders a 36 year old single male has been admitted to your ward with exacerbation of his asthma. His hearing is also moderately impaired and he wears hearing aids in both ears. After introducing yourself, you notice that his respiratory rate appears moderately fast at 28 breaths per minute. He tells you that he’s always struggled with the disease since a child, but during the early spring he tends to get worse, especially on windy days. He reports not feeling ‘too bad’ at present and that this degree of shortness of breath is ‘pretty usual’ for him. He denies coughing up any sputum, or any chest pain. He appears flushed, and is speaking in short sentences. You take his vital signs and note a BP of 140/70 and his oxygen saturation is 90% on room air. When you inspect Mr Saunders chest your note moderate use of accessory muscles and on auscultation there is wide spread respiratory wheeze.
Describe a detailed focussed health assessment of Mr Saunders carried out to address his current presentation of asthma. The essay should address the following points in your discussion.
• Describe the area of focussed assessment to be considered for Mr Saunders stating the rational for such a choice.
• Describe the normal assessment parameters of the assessment identified in the previous question
• Describe how Mr Saunders’s presentation deviates from these normal assessment parameters explaining the pathophysiological developments associated with each relevant symptom presented in the above case study.
• Mr Saunders presents with a history of asthma, from your research on asthma identify any further areas to be investigated and what further assessment needs to be conducted to collect more data.
• Explain the relationships that may exist between individual pieces of assessment data that enables you to identify a specific problem area
• Identify potential risk factors that could contribute to Mr Saunders experiencing asthma in the future.

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