1) What would be 3 nursing diagnosis for a care plan for these case studies?2) How would compose
Question Answered step-by-step 1) What would be 3 nursing diagnosis for a care plan for these case studies?2) How would compose a careplan based on these case studies and answers?Tommy HillLearning Objectives1. Describe the pathophysiology of asthma.2. Identify asthma triggers.3. Discuss the benefits and effects of anti-inflammatory and bronchodilator medications for asthma clients.4. Discuss treatment of status asthmaticus.5. Identify teaching strategies useful for cognitively impaired clients.6. Explain the correct use of inhalers. Eight-year-old Tommy Hill was admitted last night with wheezing, difficulty in breathing, and coughing. He was anxious and restless. He was accompanied by his mother who stated, “This always happens when he gets a cold.” Tommy has had numerous lung related illnesses requiring hospitalization during the last two years. This is his third visit this month to the emergency room with an asthma attack. His mother has remained with him all night, but as the nurse enters the room today, she says, “I’ll be back in a second, I have to have a cigarette.”Focus QuestionsWhat data does the nurse need today during the interview and the initial morning assessment? The nurse will data information regarding the mother’s smoking frequency history involving smoking of family members and other lung-related disorders. Also vitals signs and the child’s activity prior to his symptoms.What are possible asthma triggers Tommy and his mother need to be aware of?To begin, Tommy and his mother should be aware of a probable asthma trigger: smoke, especially after knowing that Tommy’s mother is a smoker. Even if the mother does not smoke in the same room as Tommy, smoke and cigarette particles could adhere to her garment, triggering Tommy’s asthma. Also the more common ones including, dust mites, pollen, seasonal allergies, fungi, cockroaches, animal dander, upper respiratory tract infections. Aerosol Ventolin treatments have been decreased from every hour to every four hours. Oral Prelone: 1 tsp. t.i.d. p.o. is started this morning. 02 saturation is 94% on room air. Rhonchi are scattered throughout the lung field.74Focus Questions1. What effect do Ventolin and Prelone have on Tommy’s lungs, and what side effects should the nurse be watching for?Ventolin: Bronchodilator, relaxes the smooth muscle Side effects: chest pain, hypertension, restlessness, nervousness, increased heart rate. Prelone is an steroidal ant-inflammatory that wil lreduce inflammation of the lungs for long term use to keep asthma in control. Side effects include Weight gain, Fluid retention, high blood pressure, elevated blood sugar 2. What evaluation criteria would indicate improvement in his condition?Evaluation criteria for asthma include the best PERF test and spirmometry, a normal respiratory rate, SpO2 oxygen saturation no wheezing or absent breath sounds and no trouble breathing will suggest that Tommy’s health has improved.3. If improvement does not occur and he progresses to status asthmaticus, what should the nurse anticipate would be done?The treatment plan in status asthmaticus is the provision of oxygen and continued bronchodilators such as albuterol. Tommy improves and is ready for discharge tomorrow. The nurse has scheduled a ffine with the mother to discuss how she can help Tommy prevent future attacks and better care for him as he learns to cope with this disease. In working with Tommy’s mother during hospitalization, the nurse learns that his mother is a visual learner and appears to be somewhat slow in grasping material. Tommy will be on Ventolin and Intal inhalers, and daily monitoring of his peak expiratory flow rates (PEFR).Focus Questions1. Create a visual diagram that explains the pathophysiology of asthma that could be used with Tommy’s mother, since she is a visual learner.AsthmaAirway hyperresponsiveness, bronchoconstrictionLead to chronic inflammation, increased airway edema and mucus.Treatments bronchodilators and corticosteroids for long term control of asthma.2. How could the nurse best teach Tommy’s mother about his medications, asthma triggers, and care during his attacks? By teaching him how to use inhalers and the proper techniques , and have him demonstrate back. Cleaning, avoiding asthma triggers and follow up to appointments along with his mother.76 Unfolding Case Studies: Experiencing the Realities of Clinical Nursing PracticeReferencesMiddleton, A. (1997). Managing asthma: It takes teamwork. American Journal of Nursing, 97(1)39—42.Wong, D. (1999). Whaley & Wong’s nursing care of infants and children. 6th edition. St.Louis: Mosby. Chapter 2 Pediatric Cases 3. How much responsibility can Tommy assume for his own disease management?Tommy, as the patient, even though young, he should understand the importance of asthma management and his mother is there to support him. By teaching him and guiding him he could have the best outcome when managing asthma. Health Science Science Nursing NURS 2300 301 Share QuestionEmailCopy link Comments (0)
