TinaBremmeris a 20-year-old collegestudentwithmoderatepersistentasthma. Shehas a cold. Whiledashingacrossthecampuson a coldfallday, shesuffersanasthmaattack. Hergirlfriend, whoiswithher, knowsthatTinakeepshermedicationinherbackpack. SheopensTina’spack, findsaninhaler, andgivesittoher. Tinausestheinhaler, butinsteadofachievingrelief, shegoesintobronchospasm. Sheistakentotheemergencyroomofthenearesthospital. Dataobtainedfromthenursingassessmentincludethefollowing:
• Lungsoundshavebilateralwheezes, withdiminishedsoundsatbases
• Pulseoximetry 92% onadmissiontothe ER
• Otherphysicalassessmentnormal
• Vitalsigns: temperature, 97.7°F; pulse, 110; respirations, 26 andshallow; bloodpressure, 120/86
Thepatientiscurrentlyonmedicationsthatincludealbuterolinhaler, twopuffs q4h prn, andflunisolideoralinhalant, 2 puffsbideveryday.
CaseStudyQuestions
1. ProvidetherationaleforwhyMs. Bremmerisprescribedtheseinhalers. (10 pts)
2. WhatcontraindicationsorprecautionswouldeliminatetheuseofthesedrugsforMs. Bremmer? (5 pts)
3. WhatpatientvariablesaremostimportanttoconsiderforMs. Bremmerwhenassessingherdrugtherapy? (5 pts)
4. Whataspectsofcoredrugknowledge (pharmacotherapeutics, pharmacokinetics, andpharmacodynamics) areespeciallyrelevanttoconsiderbecausetheymayinteractwiththepatientvariables? (5 pts)
5. Whichofthefindingsfromthenursingassessmentdemonstratetheeffectivenessofdrugtherapy? (5 pts)
6. Whichofthefindingsfromthenursingassessmentdemonstratepossibleadverseeffectsfromthedrugtherapy? (5 pts)
7. Whatnursingactionsareindicatedtomaximizetherapeuticeffects? (5 pts)
8. Whatnursingactionsareindicatedtominimizeadverseeffects? (5 pts)
9. WhatteachingisrequiredforMs. Bremmerregardingherdrugtherapy? Includelistofanyadditionaldataneededtodetermineappropriateteaching. (5 pts)