Discuss the co-morbidities

Friday December 17, 2021

Discuss the pathophysiology of the clinical condition, use information provided in the client handover to inform your discussion

Discuss the co-morbidities relevant to the development of the clinical condition

Choose a clinical assessment framework to base your comprehensive nursing assessment for your chosen client, obtaining both objective and subjective data.

Identify 2 diagnostic tests and discuss how the tests assist in the management of the client.

Discuss 2 medications in your chosen clinical case; include mechanisms of action, side effects and nursing considerations.

Discuss the health education needs of the chosen clinical case; include members of the multidisciplinary team that may be appropriate to deliver this education.

Discuss any psychosocial/cultural factors that may have contributed to the client’s current situation

Establish a plan of care for your client (you may present this in a table format). Your plan should include:

Four relevant nursing diagnoses

A long and short term goal for each diagnoses

Rationales

Evaluations

Reflect on your keys learning’s gained from this assessment and complete a self – assessment.
Case One

Miss Julie Kenny is a 27yr old female. Julie has been admitted to hospital with an acute exacerbation of asthma. She has just been transferred to your ward from the emergency department

Julie has a past history of moderate persistent asthma. She has had frequent admissions to hospital with exacerbations, usually waiting until her asthma has become difficult to manage before presenting to hospital.

Julie has had a persistent dry cough for the last 4 days, requiring her to use her Salbutamol inhaler several times in the last week. Julie also went away for the weekend and forgot to take her regular inhalers with her.

In addition to her Salbutamol inhaler, Julie is also supposed to take Salmeterol and Flixotide. Julie admits she doesn’t like taking all of her medications away with her and tries to manage without them. She doesn’t regularly use the Flixotide and claims it has given her “mouth infections” in the past. She doesn’t know where her asthma action plan is.
Other history includes a family history of asthma

Julie’s current weight is 115kg’s, she lives a sedentary lifestyle and work in telesales. She is single and lives alone, her apartment is in need of a good clean

She tells you she often smokes “pot” to help her sleep

Julie’s management in emergency consisted of 4 Salbutamol and 2 Atrovent nebulisers

Her current management plan is for 2-4 puffs of salbutamol hourly, she has also been commenced on oral Prednisolone 50 mg daily. The aim is for discharge as soon as possible.

The last assessment findings in the emergency department were:

o Alert and orientated

o Respiratory rate 26

o Heart rate 115 regular

o Sp02 96% on 2 litres of 02

o BP 130/75

o Widespread expiratory wheeze

o PEFR 380L/M post salbutamol ( Julie doesn’t know what her PEFR is )

o Chest X-ray normal

 

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