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    Asthma Patient CRT

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    api-252173623

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    Asthma Patient CRT

    Uploaded by

    api-252173623
    255 views2 pages

    Original Title

    asthma patient crt

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    Download as docx, pdf, or txt
    255 views2 pages

    Asthma Patient CRT

    Uploaded by

    api-252173623

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Brief Background: CG is a 16 y.o.

    high school student who was brought to the ER 2 hours ago from an
    afterschool activity because she could not breathe. She is a known asthmatic.
    Assessment Problem Statement Goals Actions Evaluation
    Last admit for
    resp. failure! 6 mos.
    ago
    Vitals: T 99.0, P 132, R
    28
    BP 120/68 %sat 88 on
    3L/min O
    2

    Observations:
    Sitting upright
    in tripod position.
    Using abd.
    muscles to exhale,
    SCM and traps to
    breathe in.
    3-4 syllable
    dyspnea
    Dry, non-
    productive, tight
    cough
    Examination:
    Distant BS with
    prolonged exp. phase
    (3:1 E:I) and
    abundant high
    Impaired
    oxygenation
    RT
    Severely
    constricted airways
    (and alveolar
    hypoventilation)
    AEB
    Elevated PaCO2
    Use of abd.
    muscles with
    exhalation
    Refractory hypoxia

    Within 8 hours
    PaCO
    2
    will
    trend toward
    normal and
    %sat will be
    above 95 on
    2L/min O
    2

    Collaborative actions:
    O2 4L/min per nasal
    prongs
    Start IV stat begin
    replacement fluids (see fluid and
    electrolytes)
    Methylprednisolone 62.5
    mg IV q6h
    Albuterol 5 mg/hour
    continuous nebulization
    Magnesium sulfate 2G IV
    once
    Independent actions:
    Continuous cardiac
    monitoring
    VS & chest auscultation
    q1h and prn
    Over-bed table to support
    patient in tripod position






















    pitched wheezes
    throughout
    Supporting Labs:
    Chemistries
    Na
    +
    147, K
    +
    4.2,
    Cl
    -
    115, HCO
    3
    -
    18,
    BUN 28, Creat 1.8
    Glucose 120
    ABGs
    PaO
    2
    88 (4L/min)
    PaCO
    2
    55, pH 7.28
    %sat 94
    Drug screen
    Theophylline level 5
    Diagnostics:
    CXR: Flattened
    diaphragms,
    hyperinflated lung
    fields

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