Discuss Nursing Strategies and Evidence-Based Rationales - Nursing Assignment Help

Assignment Task

Aim of assessment
The aim of this assessment is to enable students to:
1. Demonstrate knowledge by analyzing the information provided in the case study.
2. Apply the clinical information provided in the case study and describe this clinical information within a pathophysiological and patient focused framework.
3. Discuss nursing strategies and evidence-based rationales to manage a patient with an acute episode of asthma.
4. Discuss the pharmacological interventions related to the management of a patient with an acute episode of a patient episode of asthma.

Details
You are to answer all questions related to the case study provided. Your answers must be directly related to the clinical manifestations that your patient presents with. You must submit your work with a minimum of six references from the past 5 years including journal articles, textbook material or other appropriate evidence-based resources.
 

Case study
Peter is a 10-year-old male, weight 45Kg.
He presented to ED with worsening respiratory symptoms over the past few hours. His parents state he is unable to talk in full sentences or undertake a peak flow. In ED Peter has been given 3 x 20 minutely nebulized Salbutamol with 6LPM of O2, IVF commenced, Stat dose of Prednisone administered, Chest X-ray shows hyperinflation of
both lung fields. He was admitted to ICU due to his deteriorating respiratory function with a diagnosis of acute exacerbation of asthma.

EXCERPT OF RELEVANT ICU NOTES
Past History
Diagnosed with asthma age 3 (infrequent intermittent asthma).
Current medications: - Ventolin PRN. IUTD (immunizations up to date)
Nursing Assessment
A. Clear, speaking in single words
B. RR 43bpm, SpO2 87% RA, 92% on 6LPM O2 + nebulizer, auscultation decreased AE bibasally, inspiratory and expiratory wheeze
C. HR 162bpm, ST, peripherally warm
D. GCS 14/15 (E4, V4, M6)
E. Accessory muscle use, shoulder shrugging on inspiration, tracheal tug
F. IVF NaCl 54 ml/hr.
G.
a. Mg- low 0.60mmol/L (0.70-1.10mmol/L) all other pathology is normal.
b. BGL 9.0mmol/L
c. Beta-agonist- Salbutamol
d. Anticholinergic - Atrovent
e. IV Hydrocortisone

Question 1
Explain the pathogenesis causing the clinical manifestations with which Peter presents.

Question 2
1. Sit Peter in a High Fowlers position
– How does positioning a patient with acute asthma in a High Fowlers position assist to alleviate respiratory distress?
1. Apply and titrate oxygen
– What oxygen delivery device will you use?
– Why did you choose this device?
– How does providing supplemental oxygen work and, how will it assist Peter?

Question 3
For each medication below explain
– The mechanism of action
– Why your patient is receiving this medication in relation to her symptoms and diagnosis?

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