Title: Module 2 Case Study - Worth 10 Points
Course: NUR 1411C Nursing for the Family Part 2 > Section: Module 2

Read the following case study information and reply to the questions below in a Word (.doc or .docx) or Rich Text (.rtf) file and upload it in this tool. This assignment is worth 10 points. Question point amounts are in parenthesis following the question.

Tommy is an eight year old who was admitted to your nursing unit this evening. Tommy is a known Asthmatic and this is his third admission for asthma symptoms. His history includes upper respiratory symptoms starting two days ago with wheezing over last 36 hours. Denies fever, nausea or vomiting, but has not eaten today. Mother states she has given Albuterol MDI, 2 puffs every four hours, since last pm with no relief. Mother also reports that his doctor told them to start prednisone but mother was out and couldn’t afford to refill prescription. Mother seems agitated by this admission and states she has missed too much work related to Tommy’s breathing problems. She then leaves the room to “go have a cigarette so she can calm down."

Physical assessment:

weight 20 Kg
height 120 cm
T-38.1
HR 120
RR 32
RR 32 bilateral expiratory wheezes, decreased breath sounds at right base
O2 sat 89% room air
Moderate substernal and supraclavicular retractions, positive nasal flaring, frequent hacking cough.
Child is pale appears anxious and somewhat restless- shows no active interest in environment.

Analyze the data provided in the scenario above and answer the following questions:

Explain the precipitating factors that influence factors Tommy’s present respiratory status. (1)

Define Status Asthmaticus. (1)

Tommy is ordered the following:

IV Fluids: 1000 ml D5/1/2 NSS at 50ml/ hr
Diet: Clear liquids then advance as tolerated
Medications:

Prelone 20 mg by mouth BID
Albuterol 2.5 mg by nebulizer Q 4 hours and as needed for wheeze
Rocephin 1.2 Grams  Q 24 hrs IV in 50 ml 0f NSS over ½ hour.
PEFR before and after each Albuterol Aerosol QID
Pulse Oximeter continuously, place Oxygen by nasal canola to maintain O2 sat < 94% while awake and 90% while asleep

Discuss the use of Albuterol and oral steroids in the therapeutic management of asthma    (1)

What is the purpose of PEFR? (1)

The doctor will be discharging Tommy in a few days. He will go home on Prelone, an antibiotic and Albuterol inhalers and daily monitoring of PEFR. When teaching this mother you determine that she is a slow learner who learns best visually. During a teaching session, the mother shares that she is a single mother who works for minimum wage and has only a small Health Insurance policy that only pays part of medication costs.

Begin Asthma teaching with parent and child. Explain in layman’s terms the pathophysiology of Asthma. (2)
Discuss the best way to teach the mother about Tommy’s Medications, asthma care during attacks. (1)
Discuss prevention of asthma exacerbations. (2)
What is the Asthma Action Plan? (1)
What are common “trigger’s?" (1)
When teaching a family about asthma what factors from original history would you draw on to highlight for teaching purposes? (1)