health.docx - Running Head CASE STUDY 1 Asthma adolescence case study Student’s Name Institutional Affiliation CASE STUDY 2 Introduction Simon who is

health.docx - Running Head CASE STUDY 1 Asthma adolescence...

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Running Head: CASE STUDY 1 Asthma- adolescence case study Student’s Name: Institutional Affiliation:
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CASE STUDY 2 Introduction Simon who is 14 years old is in status asthmaticus in the emergency department. His dad reported that he was playing soccer when he started wheezing and he did not want to stop and use the inhalers. Dad said that the case had happened when he entered his teenage years. On examination, Simon had audible wheeze and is not able to complete sentences. His respiratory rate is 32 breaths per minute with the pulse oximetry reveals a SaO2 of 88% plus a pulse rate of 132. He appears a little cyanotic and is visibly distressed and anxious. When asked what medication he was taking, Dad says that Simon had just been taking his “normal puffers,” but Simon says that he had also been taking ibuprofen for a sprained ankle he picked up in training. The two nursing priority problems for Simon are impaired gas exchange and airway clearance. Priority problems and Nursing interventions Impaired Gas Exchange Simon has an impaired gas exchange which is the deficit or excess in carbon dioxide elimination and oxygenations at the alveolar-capillary membrane. It is demonstrated by his respiratory rate which is at 32 breaths per minute with the pulse oximetry reveals a SaO2 of 88% plus a pulse rate of 132. The gas is exchanged between the pulmonary capillaries and alveoli through diffusion. The diffusion of carbon dioxide and oxygen happens passively according to the differences in concentration across the barrier of the alveolar-capillary. The difference in level needs to be maintained through alveoli ventilation and pulmonary capillaries perfusion. The balance between the two is present; however certain circumstances could affect the balance causing the impaired gas exchange (Scherb et al., 2011). The dead spaces are the breath volume which does not participate in the transfer of gas. The condition which causes the collapse or the
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CASE STUDY 3 changes of the alveoli impairs the ventilation. Higher altitudes, hypoventilation plus the different oxygen-carrying capacity of blood from the lowered hemoglobin are among the factors which affect the exchange of gas. The total blood flow in pulmonary in older people is less compared to young patients. Obesity and the effects of the large fat mass on the function of lung puts the patients at the higher risks of hypoxia. Nursing Interventions 1. Administration of medical procedures The first nursing intervention for the impaired gas exchange is the administration of the humidified oxygen via the appropriate device like a face mask or nasal cannula. Simon had audible wheeze and is not able to complete sentences. The onset of hypoventilation is watched as evidenced by the rise of the somnolence following increasing or initiation oxygen therapy (Abrams & Brodie, 2017). The patient is provided with the supplementary oxygen through the 100% oxygen non-rebreathers. The rationale for this is that the early additional oxygen is
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  • Spring '16
  • dr kirimi

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