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4691 : Nursing

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Question

Assessment Details

You are to develop a concept map and answer three questions related to Acute Severe Asthma. 

Concept Map 

  • The concept map must be computer generated.
  • When researching the topic, use the pathophysiology template that is on the unit vUWS site to assist you in organising your information. The template will also assist in identifying key concepts and their relationships.
  • Concept boxes should have titles with relevant content summarised within the box.
  • The summarised content may be in point format and size 10 font (Arial or Times New Roman) may be used on the concept map.
  • Concept boxes must be linked using lines and linking words/phrases to demonstrate logical relationships between concepts.
  • For conciseness, numbers may be used to replace traditional APA referencing within concept boxes. If you use numbers, you must include a reference list in numerical order, corresponding to your references immediately after the concept map.
  • Critical thinking and creativity are essential components of the concept map. The map design needs to be visually stimulating. 

Case study

Jackson Smith, a 18 year-old male, was admitted to the Emergency Department at 9pm with severe breathless- ness. 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
PaO2: 60mmHg PaCO2: 50mmHg HCO3: 25mEq/L Lactate: 1

SaO2 90%
A diagnosis of Acute Severe Asthma was made.

Question

1. Explain the pathogenesis causing the clinical manifestations with which Jackson Smith presented with.

2. Discuss two high priority nursing strategies to manage Jackson and provide evidence-based rationales for these strategies.

3. 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.
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