Let’s apply what you have learned in the respiratory unit.

Case Study 1 Asthma Scenario

An adult patient presents to the emergency department with complaints of shortness of breath and increased work of breathing. The patient is alert and oriented times 3; skin is pink, warm and dry; BP 148/88; T 98; P92; R 24; and pulse oximetry 91% on room air. Assessment of the lung reveals expiratory wheezing throughout the lung fields. The patient has a past medical history of asthma, hypertension, and diabetes.

1. The nurse anticipates which of the following medications will be initially administered to the patient?

a) Theophylline
b) Montelukast
c) Albuterol
d) Salmeterol

2. List the steps the nurse should take to safely administer the medication.

3. What assessments should the nurse plan to complete after administering the medication?

4. The nurse plans on teaching the patient about using the albuterol inhaler at home. What information should be included?

5. What is the best method for the nurse to use to ensure that the patient is correctly using an inhaler?

Case Study 2 Allergy Scenario

A pediatric patient presents to the emergency department with complaints of shortness of breath, increased work of breathing, and a cough. The patient is alert and oriented times 3; skin is pink, warm and dry; BP 112/68; T 99; P106; R 32; and pulse oximetry 90% on room air. Assessment of the lung sounds reveals diminished lung sounds throughout all lung fields. The patient has a past medical history of peanut allergy. The mother tells you that they were at a birthday party and after consumption of a cupcake, the symptoms started.

1. The nurse anticipates that which of the following medications will be likely ordered for this patient?

a) Diphenhydramine
b) Epinephrine
c) Cetirizine
d) Guaifenesin

Case Study 3 Rheumatoid Arthritis Scenario

A 67-year-old female patient diagnosed with rheumatoid arthritis and type 2 diabetes has been prescribed prednisone for the management of her symptoms. She has been taking prednisone 10mg daily for the past 2 weeks. The patient is complaining of insomnia, increased thirst, and weight gain.

1. What are the common side effects of prednisone use?
2. How can the nurse help manage the patient’s insomnia?
3. What measures can be taken to help the patient manage her increased thirst?
4. What education should the nurse provide the patient regarding prednisone use?