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 on 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 Questions
1. According to the case study information, how would you classify the severity of D.R. asthma
attack?
2. Name the most common triggers for asthma in any given patients and specify in your answer
which ones you consider applied to D.R. on the case study.
3. Based on your knowledge and your research, please explain the factors that might be the
etiology of D.R. being an asthmatic patient.
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:
Serum glucose 412 mg/dL
Serum sodium (Na+) 156 mEq/L
Serum potassium (K+) 5.6 mEq/L
Serum chloride (Cl–) 115 mEq/L
Arterial blood gases (ABGs): pH 7.30; PaCO2 32 mmHg; PaO2 70 mmHg; HCO3– 20 mEq/L
Case Study Questions
1. Based on Ms. Brown admission’s laboratory values, could you determine what type of water
and electrolyte imbalance does she has?
2. Describe the signs and symptoms to the different types of water imbalance and described
clinical manifestation she might exhibit with the potassium level she has.
3. In the specific case presented which would be the most appropriate treatment for Ms. Brown
and why?
4. What the ABGs from Ms. Brown indicate regarding her acid-base imbalance?
5. Based on your readings and your research define and describe Anion Gaps and its clinical
significance.
Solution:
Pulmonary Function
The D. R. asthma attack can be classified as Severe persistent asthma. This is the type of asthma in which a person has symptoms several times in a day and may occur almost every day. A patient is also likely to have symptoms many nights weekly. In the case of D.R, he is experiencing an increased SOB, wheezing, fatigue, cough, stuffy nose, watery eye, and postnasal drainage. These symptoms began four days ago with the peak-flow rate ranging between 65-70%. Also, he has nighttime symptoms for 3 nights in the last weeks which is a major feature in severe persistent asthma. Another symptom that confirms this classification is the fact that D. R. has been trying to use an albuterol inhaler, which is not enough for the treatment of asthmatic episodes. This is consistent with Song et al. (2019) argument that a key feature of this kind of asthma is that it does not respond well to medications even when taken regularly.
The most common trigger for asthma in any given patient include allergens, infections, exercise, abrupt change in weather as well as exposure to airway irritants such as tobacco smoke. The trigger that applies to the D.R case study is the abrupt change of weather. In this light…Click link below to purchase full tutorial at $10