Sacred Heart College

College of Nursing
Lucena City

FACULTY MARKED ASSIGNMENT 4

1st Semester SY: 2020-2021
NCM112 – OXYGENATION
Prepared by: Oscar R. Reyes II, MSN, RN, CNN
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GENERAL INSTRUCTIONS:
1. Use separate sheet to answer the following questions.
2. Save your work in a Google Docs file or Microsoft Word, Arial 12 font and save using
the following format: ModuleNumber_LASTNAME_Firstname
3. NO CHEATING!
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A. IDENTIFICATION

Indicate whether the following clinical manifestations are most characteristic of asthma
(A), chronic obstructive pulmonary disease (COPD) (C), or both (B). Shade A, B, or C.
1. Wheezing
2. Weight loss
3. Barrel chest
4. Polycythemia
5. Cor pulmonale
6. Persistent cough
7. Flattened diaphragm
8. Decreased breath sounds
9. Increased total lung capacity
10. Frequent sputum production
11. Increased fractional exhaled nitric oxide (FENO)

B. FILL IN THE BLANKS. Use separate sheet for these questions.

Indicate the role or relationship of the following agents to asthma (51-53).

Agent Role or Relationship to Asthma

Salicylates
α-Adrenergic blockers
Beer and wine

54. Which medications are the most effective in improving asthma control by reducing
bronchial hyperresponsiveness, blocking the late-phase reaction, and inhibiting
migration of inflammatory cells (select all that apply)?
a. Zileuton (Zyflo CR)
b. Omalizumab (Xolair)
c. Fluticasone (Flovent)
d. Salmeterol (Serevent)
e. Montelukast (Singulair)
 Sacred Heart College
College of Nursing
Lucena City

f. Budesonide (Pulmicort)
g. Beclomethasone (Qvar)
h. Methylxanthine (theophylline)
i. Mometasone (Asmanex Twisthaler)

CASE STUDY

Elsa is a 35-year-old mother of two school-age boys who arrives via ambulance in the
emergency department (ED) with severe wheezing, dyspnea, and anxiety. She was in
the emergency department 6 hours earlier with an asthma attack.
She was treated during previous emergency department visit with nebulized albuterol
and responded quickly. She was allergic to cigarette smoke. She began to experience
increasing tightness in her chest and shortness of breath when she returned home
following her previous emergency department visit. She used the albuterol several times
after she returned home with no relief. She was diagnosed with asthma 2 years ago.
She does not have a health care provider and is not on any medications

Upon physical examination, she was sitting upright and using accessory muscles to
breathe, talks in one- to three-word sentences, RR: 34 and shallow, audible wheezing,
auscultation of lung fields reveals no air movement in lower lobes, HR: 126 bpm, noted
to be extremely anxious and restless

Diagnostic studies revealed ABGs: pH 7.46, PaCO2 36 mm Hg, PaO2 76 mm Hg, O2

saturation 88%; Chest x-ray: bilateral lung hyperinflation with lower lobe atelectasis;
CBC with differential and electrolytes: within normal limits.

An IV is started in her left forearm with normal saline infusing at 100 mL/hr.

Guide Questions
Using a separate sheet of paper, answer the following questions:
1. What other assessment information should be obtained from Elsa?
2. What is the priority collaborative intervention for Elsa?
3. What data obtained from the brief history, physical examination, and diagnostic
studies indicate that Elsa is experiencing a severe or life-threatening asthma attack?
4. Identify two classifications of medications the nurse should expect to be administered
to this patient. What effect is expected with these medications?
5. In addition to medication administration and close monitoring of the patient, what
other key role can the nurse take in helping the patient through this episode?
6. What value would peak expiratory flow rate (PEFR) measures have during the care of
Elsa?
7. What health care teaching should be included for this patient related to her asthma?
8. Based on the assessment data presented, what are the priority nursing diagnoses?
What are the collaborative problems?