ICU Case Study PDF
ICU Case Study PDF
ICU Case Study PDF
ii
MANAGEMENT
i
CASE STUDY i
DOA: i13/08/20
Age:43
Gender: iMale
Race: iI-Taukei
Religion: iMethodist
Social ihistory: iPrevious ismoker, iquit i11 iyears iago. iConsumes ikava ioccasionally iand
inon- ialcoholic
This i43-year-old iI-Taukei, imale iwas ireferred ifrom iNuffield ihealth icenter ion ithe
i13/08/20 ito ithe iemergency idepartment iin iCWM ihospital iwith ithe idiagnosis iof ilife-
threatening iasthma. iHe iwas ithen iadmitted ito ithe iIntensive iCare iUnit i(ICU). iThe iclient
ipresented ihimself ito iNuffield ihealth icenter iwith ithe ichief icomplain iof iproductive icough
iand ifever ifor i3 idays iand ichest itightness iwhich icaused ihim ishortness iof ibreath ion ithat
imorning iand ihe iwas iunable ito ispeak. iHe iwas igiven isalbutamol inebulizer iat ithe ihealth
icenter. iUpon iadmission iin iICU, ihe iwas iintubated iwith i7.5 iendotracheal itube iat i22cm
ilip ilevel. iHe iwas ia icategory i5 ipatient inursed ion iventilator iwith iSIMV imode iwith
iFio2- i100%, iPEEP- i5cm iH2O, iPS- i100 iH2O, iVR-15 ib/min, iTV- i400 ib/min. iUpon
iauscultation, iextensive ibilateral iwheezes iwere iheard. iA iFoley icatheter isize i16 iwas
iinserted ifor ithe iurine ito idrain iand ia iright ifemoral icentral iline iwas iinserted. i
Asthma iis ia ivery icommon imedical icondition iin iFiji iand iother icountries. iIt iis ia imedical
idisorder iwhich iaffects ithe iairways iwhich iis ithe ibreathing itubes iwhich itransmits iair ito
iour ilungs. iAsthma iis ifound ito ibe ia ilong-term iand ichronic idisease. iBasically, iit iis ia
icondition ithat iintermittently ierratically iinflames ithe iairways iin ithe ilungs, ithis
iinflammation ileads ito iswelling iof iairways iand ithus, inarrowing iof ithe iairways ioccur.
iPeriodically, iindividuals iwith iasthma ifind iit idifficult ito ibreathe iin iand iout, iit ican ibe
isaid ithat iit iis ilike ibreathing ifrom ia ithin istraw. iIndividuals idiagnosed iwith iasthma
imight iexperience isigns ithat ivary ifrom iminor ito isevere iand ithat imay ioccur iinfrequently
ipersons iof iall iages iand ioften istarts iduring ichildhood. iThe iprecise icause iof iasthma iis
iunidentified, iand ithe icauses imay idiffer ifrom iperson ito iperson. iHowever, iasthma iis
ifrequently ithe ioutcome iof ia isolid ireaction iof ithe iimmune isystem ito ian iallergen iin ithe
iatmosphere. iFor iexample, iacquaintance ito ian iallergen iin ithe isetting, ilike iragweed, ican
imake iyour iairways irespond ipowerfully. iOther iindividuals iexposed ito ithe isame iallergen
imay inot ireact iat iall, ior itheir ireaction ican idiffer. iThe ipurpose ione iperson ireacts ito ian
iexposure iwhile iothers ido inot iis inot icompletely iunderstood, ithough iit imay ibe ipartially
Is idefined ias iprogressive irespiratory ifailure idue ito iasthma, irefractory ito itreatment iwith
2. Stress- ihe iis ithe isole ibread iwinner iand ihe isells igrog ito isupport ihis ifamily i
4. Previous ismoker
imedical iconditions.
iblood.
Adrenalin i Adrenalin iacts iquickly ito breathing iproblems Adrenalin iis icontraindicated
2013)
iwall. igallbladder.
idisease), ipelvic
iinflammatory idisease
icalled icephalosporin
ireaction ito iease iswelling iand igradual iweight igain iof ithe ieye.
iSteroids iare iused iwith iother ispinning isensation icaused iby ithe
Haver, 2013).
iuseful ifor ithe itreatment iof ivomiting, idiarrhea, iCloxacillin ior iother
iand iotitis iexterna. iIt iis inot iItching, irash, ifever, iPenicillin,
• i iCardiovascular
i(infection iof ithe ilung) iand iblood ior iprotein iin ithe
icloxacillin iis
iadministered ifor ia
iprolonged iduration.
iirritation iketoacidosis
(Fanta, Cristiano, & Haver,
cough
2013). excess ibody iacid
hoarseness
low iamount iof
sore ithroat
ipotassium iin ithe
iblood
diminished iblood
prolonged iQT
abnormal iheart
irhythm
ibirth
seizures
Heparin i Heparin iis iused ito iprevent bruising imore ieasily. hypersensitivity, ipast ior
iin ipeople iwho ihave icertain ilonger ito istop. ithrombocytopenia iand
increased iliver
icomponents
irestless, iexcitable
iand/or ishaky.
iheartbeat.
imouth.
dry imouth.
2013).
imuscles
iof inasal
iflaring
5. Monitor
ioxygen
isaturation
ii
6. Monitor
iarterial
iblood
igasses
ivalues
7. Maintain
ihead iof
ithe ibed
ielevated i
8. Encourage
iclient ito
iuse
ipursed-lip
ibreathing
ifor
iexhalation
iacute imedical iward iafter iday i5 iof iICU icare, ihowever iupon idischarge:
Client iwill ibe iadvised iwell ion imedication icompliance, iwhat ithe imedications ido,
ihow i(route) ito itake ithe imedications iand iwhen i(time) itake imedications.
Client iwould ibe ieducated ion idiet iand inutrition, iaccording ito ihis icondition.
Client iwould ibe ieducated ion ihome icare iand isimple iactivities ifor idaily iexcises ito
The iclient iwill ibe iadvised ito ipresent ihimself ito ithe inearest ihealth ifacility iif ihe
iexperience iany iunusual isymptoms ior ichanges iin ihis icondition iand ialso ipresent
Client iwill ibe ibooked ifor idischarge iclinic iand iwill ibe igiven ithe iclinic idate iand
Fanta, iC. iH., iCristiano, iM. iL., i& iHaver, iE. iK. i(2013). iThe iharvard imedical ischool
iguide ito itaking icontrol iof iasthma. iNew iYork: iFree ipress.Pg ino. i121-125
Gulledge, iJ., i& iBeard, iS. i(2015). iAsthma iManagement; iClinical ipathways, iGuidelines
iand iPatient iEducation. iUnited iStates iof iAmerica: iAspen iPublication.Pg ino.132,
i217-129