Concordia College College of Nursing

Case Study On Bronchial Asthma

Prepared By: De Castro, Richelle Sandriel C. BSN III-D Submitted To: Ms. Susie May Jardio RN, RM, MSN I. INTRODUCTION

Asthma is a chronic inflammatory respiratory disorder that causes recurrent episodes of wheezing, breathlessness, chest tightness and cough, especially at night or in the early morning. These asthma episodes are associated with airflow limitation or obstruction that is reversible either spontaneously or with treatment. Asthma usually begins in childhood or adolescence, but it also may first appear during adult years. While the symptoms may be similar, certain important aspects of asthma are different in children and adults. Bronchial asthma is the more correct name for the common form of asthma. The term 'bronchial' is used to differentiate it from 'cardiac' asthma, which is a separate condition that is caused by heart failure. Although the two types of asthma have similar symptoms, including wheezing (a whistling sound in the chest) and shortness of breath, they have quite different causes. Bronchial asthma is usually intrinsic (no cause can be demonstrated), but is occasionally caused by a specific allergy (such as allergy to mold, dander, dust). This case study is a thorough learning about Bronchial Asthma, which contains a study about the normal physiology of the respiratory system, pathological physiology of the disease, a thorough assessment of the patient with said illness, applied nursing care plans to patients having this kind or disease, and discharge planning to a patient to limit the recurrence of the attack or if not proper management and care to be given during the time of asthma attack. II. OBJECTIVES OF THE STUDY At the end of the case study, the student will be able to: Know what Bronchial Asthma is all about. Apply the knowledge that they have learned in the floor. III. PATIENTS PROFILE Name: T.M Address: Western Bicutan, Taguig Age: 25 years old Date of Birth: November 16, 1984 Sex: Female Nationality: Filipino Religion: Roman Catholic Date & Time of Admission: May 17, 2010 (03:25 pm) Mode of Arrival: Wheelchair Chief Complaint: Pruritic Rashes Source of Information: Patient, Chart IV. HISTORY OF PRESENT ILLNESS The patient was diagnosed with bronchial asthma since 2008 given Salbutamol nebulization as necessary. 2 days prior to admission, the patient experienced non productive cough, watery nasal discharge, and (-) fever, and decreases in appetite. 1 day prior to admission, the patient experienced difficulty of breathing, excessively vomit once.

Few hours prior to admission, they went to San Juan de Dios Hospital for consultation, the patient experienced persistence of difficulty of breathing.

V. LABORATORY WORKS NAME OF TEST Complete Blood Count Purpose: CBC is ordered to aid in the detection of anemias; hydration status; and as part of routine hospital admission test. The differential WBC is necessary for determining the type of infection. NORMALVALUE RBC: 4-6 x 10/L Hct: 0.37- 0.47 Hgb: 110- 160 gm/L WBC: 5-10 x 10 /L Lymphocytes:0.25-0.35 Segmenters: 0.50-0.65 Eosinophil: 0.01-0.06 RESULTS 4.28 0.36 111 11.3 0.25 0.74 0.01 SIGNIFICANCE Increased segmenters (mature neutrophils) reflect a bacterial infection since this are the bodys first line of defense against acute bacterial invasion. Lymphocytes are decreased during early acute bacterial infection and only increase late in bacterial infections but continue to function during the chronic phase.

VI. DRUG STUDY Generic/Brand Name 1.Salbutamol Action . Indication/ Classification Adverse Reaction Nursing Responsibility Assess cardio-respiratory function: BP, heart rate and rhythm and breath sounds Determine history of previous medication and ability to self medicate to prevent additive. Monitor for evidence of allergic reaction and paradoxical bronchospasm.

DISCHARGE SUMMARY Medication Patient will be compliant to continued medication regimen Exercise Patient will verbalize need importance of exercise and demonstrate proper initiation of appropriate exercise. Treatment Patient will know appropriate treatment regimen and verbalize compliance. Hygiene Outpatient Diet Spiritual VII. PATHOPHYSIOLOGY

Predisposing Factor -Atopy -Female gender

Causal Factors -Exposure to indoor and outdoor allergens -Occupational sensitizers

Contributing Factors -Respriratory infections -Air pollution -Others: diet, small size at birth

Inflammation
Hyperresponsiveness of airways

Airflow limitation

-Risk Factors for Exacerbations -Allergens -Respiratory infections -Exercise and hyperventilation -Weather changes -Exposure to sulfur dioxide -Exposure to food, additives, medications

Symptoms Wheezing Cough Dyspnea Chest tightness