Benji Smith Case Study - Nursing Assignment Help

Assignment Task:

Clinical Scenario: Benji Smith

Benji is an 11-year-old boy with asthma diagnosed at age 7. His usual asthma treatment is salbutamol 2 puffs prn. For the last week, Benji has been experiencing an upper respiratory tract infection (bacterial) with unresolved cough and breathlessness. He has been taking cough syrup and salbutamol 2 puffs every 4 hours but this has not improved his symptoms. 

Admission to the ED

Benji presented to the hospital with a moderate exacerbation of asthma. On presentation, he was speaking in phrases and had an audible wheeze. His mother who was also present provided a history of Benji’s asthma. Both Benji and his mother initially reported that Benji was well until he caught a cold. However, when probing specifically about his asthma symptoms and overall control Benji acknowledged that he had difficulty playing sport especially during his soccer games on Saturdays; he wheezed and coughed when laughing, he avoided running around with his mates to prevent symptoms. 30 minutes after admission Benji’s mother alerts medical staff to assist as Benji appears to be in increased distressed with increased agitation/distress, tracheal tug and moderate accessory muscle use is tachycardic and is only able to speak in single words with great difficulty. 

Admission observations

Temperature 38.6 degrees C

The pulse rate of 110 beats per minute

Respiratory rate of 24 breaths per minute

SpO2 94% on room air 

30 Minutes post-admission

Temperature 38.4 degrees C

The pulse rate of 130 beats per minute

Respiratory rate of 30 breaths per minute

SpO2 90% on air 

Medical orders

Salbutamol 100 μg 12 puffs via a metered-dose inhaler (MDI) 20 minutely for 3 times

Oral Prednisolone 1mg/kg (maximum 60mg) initially continuing for 1 – 2 days

If SpO2 under 93% administer 2L of oxygen

Ipratropium 8 puffs (20μg/puff) - immediately after each Salbutamol dose via a spacer (20 minutely for 3 times). 

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