Assignment task:
Selena is a 19 year old female who presented to the emergency department complaining of shortness of breath, wheezing, and feeling fatigued. She stated my chest feels tight and I cannot catch my breath". She reported that she was visiting her friend who has pets prior to the episode of her asthma attack. Selena has an allergy to cats and ragweed. On assessment you noted that Selena appears to be in moderate to severe respiratory distress with 2-3 word dyspnea. Vital Signs BP 140/80, Pulse 120, Respirations 26 laboured and shallow, O2 sat 88% room air. Respiratory 2-3 words dyspnea, diffuse bilateral wheezing on expiration, Coughing +++, decreased breath sounds to the bases of the lungs, use of accessory muscles prominent ,tachycardia, WBC 12.0x1x9/L
Chest Xray -hyperinflated lungs with no indication of infection/pneumonia.Selena was diagnosed with acute asthmatic exacerbation .She was ordered the following medications.
1. Salbutamol (Ventolin ] 5 mg q1 hr PRN by nebulizer
2. Ipatropium bromide {Atrovent] 500mcg by nebulizer PRN [max 3 doses]
3. Prednisolone 50mg po
Discussion Questions.
Q1. What is most likely trigger of Selena's asthma attack? What type of asthma is she experiencing-extrinsic or intrinsic? Explain your answer in detail?
Q2. What are the three pathophysiologic changes related to inflammation during an attack would you expect in a patient. Explain in detail.
Q3. Provide the pathophysiology of how airway obstruction develops in Selena with the type of asthma exacerbation identified in question 1.