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Pulmonary Function:
D.R. is a 27-year-old man, who presents to the nurse practitioner at the Family Care Clinic complaining of increasing SOB, wheezing, fatigue, cough, stuffy nose, watery eyes, and postnasal drainage—all of which began four days ago. Three days ago, he began monitoring his peak flow rates several times a day. His peak flow rates have ranged from 65-70% of his regular baseline with nighttime symptoms for 3 nights on the last week and often have been at the lower limit of that range in the morning. Three days ago, he also began to self-treat with frequent albuterol nebulizer therapy. He reports that usually his albuterol inhaler provides him with relief from his asthma symptoms, but this is no longer enough treatment for this asthmatic episode.
Case Study Questions
According to the case study information, how would you classify the severity of D.R. asthma attack?
Name the most common triggers for asthma in any given patients and specify in your answer which ones you consider applied to D.R. on the case study.
Based on your knowledge and your research, please explain the factors that might be the etiology of D.R. being an asthmatic patient.
Fluid, Electrolyte and Acid-Base Homeostasis:
Ms. Brown is a 70-year-old woman with type 2 diabetes mellitus who has been too ill to get out of bed for 2 days. She has had a severe cough and has been unable to eat or drink during this time. On admission, her laboratory values show the following:
Serum glucose 412 mg/dL
Serum sodium (Na+) 156 mEq/L
Serum potassium (K+) 5.6 mEq/L
Serum chloride (Cl–) 115 mEq/L
Arterial blood gases (ABGs): pH 7.30; PaCO2 32 mmHg; PaO2 70 mmHg; HCO3– 20 mEq/L
Case Study Questions
Based on Ms. Brown admission’s laboratory values, could you determine what type of water and electrolyte imbalance does she has?
Describe the signs and symptoms to the different types of water imbalance and described clinical manifestation she might exhibit with the potassium level she has.
In the specific case presented which would be the most appropriate treatment for Ms. Brown and why?
What the ABGs from Ms. Brown indicate regarding her acid-base imbalance?
Based on your readings and your research define and describe Anion Gaps and its clinical significance.
Submission Instructions:
You must complete both case studies
Your initial post should be at least 600 words per case study, formatted and cited in current APA style 7 edition with support from at least 2 academic sources within the last 5 years.
You should respond to at least two peers by extending or adding additional nuance to their posts. Each response should be 150 words and use one reference.
All replies must be constructive.
Read and watch the lecture resources & materials below early in the week to help you respond to the discussion questions and to complete your assignment(s).
(Note: The citations below are provided for your research convenience. You should always cross reference the current APA guide for correct styling of citations and references in your academic work.)
ReadDelugash, L., Story, L. (2020).Chapter 5
CH05.pptxDownload CH05.pptx
Chapter 6
CH06.pptxDownload CH06.pptx
WatchChapter 5: Pulmonary Function (56:31)
STU. (2021). Chapter 5: Pulmonary function [Video]. Studio.
Chapter 6: Fluid, Electrolyte, and Acid-Base Homeostasis (36:11)
STU. (2021). Chapter 6: Fluid, electrolyte, and acid-base homeostasis [Video]. Studio.
Gas exchange and partial pressures (4:10)
Alila Medical Media. (2019, May 6). Gas exchange and partial pressures, animation [Video]. YouTube. https://youtu.be/6qnSsV2syUELinks to an external site.
Acid base balance (5:44)
Alila Medical Media. (2017, October 10). Acid base balance, animation [Video]. YouTube. https://youtu.be/VzEEs00v-JULinks to an external site.
Online Materials & Resources:
Diagnosing and managing asthmaLinks to an external site.
U.S. Department of Health and Human Services, National Institutes of Health, & National Heart, Lung, and Blood Institute. (2011). Asthma care quick reference: Diagnosing and managing asthma. https://www.nhlbi.nih.gov/files/docs/guidelines/as…
General characteristics of patients with electrolyte imbalance admitted to ERLinks to an external site.
Balcı, A. K., Koksal, O., Kose, A., Armagan, E., Ozdemir, F., Inal, T., & Oner, N. (2013). General characteristics of patients with electrolyte imbalance admitted to emergency department. World journal of emergency medicine, 4(2), 113–116. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC41298…
How lungs workLinks to an external site.
How lungs work: The respiratory system. (2020, April 2). American Lung Association. https://www.lung.org/lung-health-and-diseases/how-…
Respiratory rate and Childhood PneumoniaLinks to an external site.
Ginsburg, A. S., Lenahan, J. L., Izadnegahdar, R., & Ansermino, J. M. (2018). A systematic review of tools to measure respiratory rate in order to identify childhood pneumonia. American Journal of Respiratory and Critical Care Medicine, 197(9), 1116-1127. https://www.atsjournals.org/doi/full/10.1164/rccm….
Centers for Disease Control and PreventionLinks to an external site.
Home page. (2020, July 16). Centers for Disease Control and Prevention. https://www.cdc.gov/
Gas ExchangeLinks to an external site.
Gas exchange. (2020, October 8). MedlinePlus – Health Information from the National Library of Medicine. https://medlineplus.gov/ency/anatomyvideos/000059….
Lung cancer—Patient versionLinks to an external site.
National Institutes of Health. (n.d.). Lung cancer—Patient version. National Cancer Institute. https://www.cancer.gov/types/lung
Health topicsLinks to an external site.
Health topics. (n.d.). NHLBI, NIH. https://www.nhlbi.nih.gov/health-topics/
Influenza (seasonal)Links to an external site.
Influenza (Seasonal). (2018, November 6). WHO | World Health Organization. https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)
TuberculosisLinks to an external site.
Tuberculosis (TB). (2020, March 24). WHO | World Health Organization. https://www.who.int/news-room/fact-sheets/detail/t…
Patients with electrolyte imbalance admitted to emergency departmentLinks to an external site.
Balcı, A. K., Koksal, O., Kose, A., Armagan, E., Ozdemir, F., Inal, T., & Oner, N. (2013). General characteristics of patients with electrolyte imbalance admitted to emergency department. World journal of emergency medicine, 4(2), 113–116. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC41298…
Homeostasis – Part-4: Fluid balanceLinks to an external site.
Docherty, B., & Foudy, C. (2006, April 25). Homeostasis – Part 4: Fluid balance. Nursing Times, 102(17), 22. https://www.nursingtimes.net/clinical-archive/publ…
Fluid and electrolyte balanceLinks to an external site.
Fluid and electrolyte balance. (2020, October 1). MedlinePlus – Health Information from the National Library of Medicine. https://medlineplus.gov/fluidandelectrolytebalance…
