Question

Case Study: Asthma

A 6 year old male has coughing with audible expiratory wheezes and dyspnea. The child is pale, skin is moist and cool and he has difficulty speaking more than a few words before stopping to catch his breath. His parents state the difficult breathing had a rapid onset approximately 1 hour earlier when he was playing with the neighbor’s dog. The child has a history of previous asthma attacks, primarily after visiting his aunt’s home where there are cats.

Assessment of the child shows T 98.6, P 120, R 40 and labored. Bilateral rales are heard on auscultation, louder on expiration but also present on inspiration.

1. Discuss what brought about this current episode (2 points)

2. Was there a history of previous attacks and what were they related to? (2 points)

3. What physiologic changes occur during an acute asthmatic episode (refer to your text) (8 points)

4. How would this particular boy subjectively describe dyspnea (2 points)

5. List the assessment findings and clearly indicate if they normal/abnormal and list a reason the value would be abnormal (10 points)

6. What test can be performed to reveal the degree of airway obstruction? (2 points)

7. What test could be considered to help gain information on possible triggers? (2 points)

8. Briefly describe how bronchodilators and corticosteroids help in the treatment of asthma (4 points)

9. When considering patient education make a list of items that you could tell or show the parents/boy (6 points)

Answer 1

1).

In the given case, the patient had the history of asthma after exposure to cats, and in the current situation, he developed acute asthmatic attack after playing with neighbor's dog. Means, the animal dander is triggering asthma in this patient.

2). Yes, the patient had the previous history of asthmatic attack when exposed to cats. Means, he animal dander is triggering asthma in this patient.

3). Asthma is a chronic inflammatory disease of the airways. During an acute attack, the patient suffers from difficulty in breathing (dyspnea) due to the bronchoconstriction and accumulation of mucus (causes wheezing), dry cough, tightness in the chest and bronchospasm.

4). The boy's sign of dyspnea - "difficulty speaking more than a few words before stopping to catch his breath"