Posted: January 25th, 2023
Pulmonary Function:
D.R. is a 27-year-old man, who presents to the nurse practitioner at the Family Care Clinic complaining of increasing SOB, wheezing, fatigue, cough, stuffy nose, watery eyes, and postnasal drainage—all of which began four days ago. Three days ago, he began monitoring his peak flow rates several times a day. His peak flow rates have ranged from 65-70% of his regular baseline with nighttime symptoms for 3 nights in the last week and often have been at the lower limit of that range in the morning. Three days ago, he also began to self-treat with frequent albuterol nebulizer therapy. He reports that usually, his albuterol inhaler provides him with relief from his asthma symptoms, but this is no longer enough treatment for this asthmatic episode.
Case Study 1 Questions:
Fluid, Electrolyte, and Acid-Base Homeostasis:
Ms. Brown is a 70-year-old woman with type 2 diabetes mellitus who has been too ill to get out of bed for 2 days. She has had a severe cough and has been unable to eat or drink during this time. On admission, her laboratory values show the following:
Case Study 2 Questions:
Submission Instructions:
SOLUTION
The patient, D.R., is experiencing an exacerbation of asthma symptoms, including shortness of breath, wheezing, fatigue, cough, stuffy nose, watery eyes, and postnasal drainage. He has been monitoring his peak flow rates, which have been lower than his baseline, and using albuterol nebulizer therapy for self-treatment, but his symptoms have not improved.
The nurse practitioner should assess the patient’s asthma severity, perform a physical examination and lung function tests, and consider adjusting the patient’s treatment plan, including increasing the frequency or dose of bronchodilators, prescribing oral steroids and antibiotics if there is evidence of infection, and providing education on asthma management and triggers.
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