Case Study Mrs. Hogan PDF

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Mrs. Hogan case study nus110...

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1. S/S Nurse might note during Mrs. Hogan assessment? Some other signs and symptoms the nurse might note during the assessment would be capillary refill, sputum, skin color, fatigue, and dizziness. 2. What position would the nurse place Mrs. Hogan? Why?

Lopez 2 The nurse would position Mrs. Hogan in semi-fowlers or fowlers. This allows free movement of the diaphragm and for the chest wall to fully expand so that she can breathe easier (Taylor, et al., 2019) 3. Identify at least five s/s that indicate Mrs. Hogan is not responding to treatment and may be developing status asthmaticus. Some signs and symptoms that Mrs. Hogan might experience that indicate she is experiencing status asthmaticus are trouble speaking, confusion, blue tint to skin, neck, back, or abdominal pain, and loss of consciousness (Loengard, 2021). 4. Mrs. Hogan took her albuterol and beclomethasone prior to coming in. How do these medications work? Albuterol is a bronchodilator. It relaxes the muscles in the airways, which expands the bronchioles which will increase air into the lungs (Durbin, 2021). Beclomethasone is a steroid. It prevents the body from releasing substances that cause inflammation. Steroids also decrease the immune system activity. This medication is commonly used to treat congestion, sneezing, and runny nose usually caused by seasonal or year round allergies (Multum, 2021). 5. Discuss the adverse effects Mrs. Hogan may experience with the albuterol nebulizer treatment. Adverse effects that Mrs. Hogan may experience due to the albuterol nebulizer treatment could be tremors or shaking, tachycardia, lung spasms, allergic reaction, and hyopkalemia (Chang & Nguyen, 2020) 6. Physiologically, what is happening to Mrs. Hogan’s lungs during an asthma attack? During an asthma attack, the airways will become inflamed and swollen. Bronchoconstriction occurs which narrows the bronchioles. This decreases the amount of air

Lopez 3 inside the lungs, making it harder to breathe. Mucus secretion will increase as well, making it difficult for Mrs. Hogan to breathe which causes wheezing (AAFA, 2019). 7. In order of priority, Identify three nursing dx for Mrs. Hogan’s asthma exacerbation Ineffective tissue perfusion related to compromised blood flow as evidenced by BP 142/96 and O2 86% on room air. Ineffective airway clearance related to excessive or thick secretion as evidenced by wheezing and rhonchi sounds. Ineffective breathing pattern related to exposure to noxious chemical as evidenced by RR of 34 bpm. (Carpenito, 2019) 8. Write three outcome goals for Mrs. Hogan’s diagnosis of ineffective breathing pattern. Mrs. Hogan will have a respiratory rate of 30 bpm by discharge. Mrs. Hogan will have eupnea by discharge. Mrs. Hogan will have oxygen saturation of 95% by discharge. 9. What questions could the nurse ask (why?) to assess cause of Mrs. Hogan’s asthma exacerbation? Were you doing your husband’s laundry? – this could have been the cause of her asthma attack. Her husband works for an asbestos removal company, and if she was doing his laundry she could have inhaled the asbestos particles. Where were you doing laundry? – if she where doing it outside, maybe there was pollen or particles in the air that she inhaled which caused her asthma attack to begin.

Lopez 4 Did you use any new laundry detergent? – this could have caused an allergic reaction triggering an asthma attack. 10. What other questions could the nurse ask to get a better sense of Mrs. Hogan’s asthma? How long have you had asthma? What causes you to have an asthma attack? What helps you during an asthma attack? 11. Which steps from Mrs. Hogan use of the inhaler are of concern and why? Mrs. Hogan should take a deep breath and exhale, then place the inhaler in her mouth. She should place her teeth over the mouthpiece with lips closed. Mrs. Hogan should not take breaths after putting the inhaler in her mouth to make sure not to inhale any extra medication. She should take a deep breath while pressing down on the inhaler and hold her breath for 510 seconds to ensure the medication reaches all throughout her bronchioles. She should exhale slowly, not like blowing out a candle to make sure the medication is distributed inside the lungs (Taylor, et al., 2019). 12. Discuss three nursing interventions to help decrease Mrs. Hogan’s risk of another asthma exacerbation. Take periods of rest between activities – this can help prevent fatigue and give Mrs. Hogan a chance to catch her breath. Use pursed-lip breathing for exhalation – this can improve Mrs. Hogan’s breathing pattern Avoid areas with high pollen – inhaling pollen is a common cause for asthma attacks and avoiding places with high pollen can reduce the chances of an asthma attack

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References Taylor, C., Pamela, L., Bartlett, J.L. (2019). Fundamentals of Nursing: The Art and Science of Person Centered-Care (9th). Wolters Kluwer. Loengard, A. (2021, October, 2). An Overview of Status Asthmaticus. VeryWellHealth. https://www.verywellhealth.com/status-asthmaticus-overview-3866901 Durbin, K. (2021, January, 14) Albuterol Inhalation. Drugs.com https://www.drugs.com/albuterol.html

Lopez 6 Multum, C. (2021, June, 4). Beclomethasone nasal. Drugs.com https://www.drugs.com/mtm/beclomethasone-nasal.html Chang, H., Nguyen, M. (2020, June, 8). Albuterol nebulizer (Accuneb). GoodRx.com https://www.goodrx.com/accuneb/what-is#side-effects AAFA Community Services (2019, June, 4). What Japens in Your Airways When You Have Asthma? AAFA.org. https://community.aafa.org/blog/what-happens-in-your-airwayswhen-you-have-asthma Carpenito, L. (2017). Nursing Diagnosis: Application to Clinical Practices. (15th ed). Wolters Kluwer....