Lucinda’s asthma is well controlled with a daily inhalation (morning) of Beclomethasone. When she has the occasional common cold, she also requires salbutamol to relieve her asthma symptoms.Three days after her mother developed a chest infection, Lucinda began to feel unwell. She became dyspnoeic within a day and had a temperature of 39.5 degrees Celsius. She wheezed and coughed and experienced bouts of chest tightness. Within a few hours her condition deteriorated, and her mother rushed her to the Emergency Department. A primary and secondary survey were done by the nurse practitioner together with the medical officer.They found the following:Vital signsRR: 32 bpm and shallowSpO2: 90% on room airBP: 160/90 mmHg (MAP 113 mmHg)HR 125 bpmTemp: 38.5 oCRespiratory assessmentLucinda was using her accessory muscles to help her breathe and on auscultation she had:decreased breath soundsabnormal breath sounds on inspiration and expirationShe was also having difficulties in completing sentences in one breath due to her dyspnoea. Venous blood gases:pHPvO2PvCO2Bicarbonate 30 mmol/L (ref range: 23 – 29mmol/L)7.29 (ref range: 7.31 – 7.41)25 mmHg (ref range: 30mmHg – 40mmHg) 55 mmHg (ref range: 41mmHg – 51mmHg)In the short time since Lucinda had arrived in the ED, her peripheral SpO2 saturation level had dropped further to 88%.Therapeutic interventionsThe nurse caring for her administered Salbutamol 0.5 mL with 3.0 mL normal saline through a nebuliser with oxygen for 10 minutes. The nurse also inserted an intravenous cannula in case Lucinda deteriorated further and required intravenous corticosteroids.Supplemental oxygen at 6L/min with humidification was administered. SpO2 target was 96%.

Question Lucinda, a 32-year-old woman, has had asthma since she was a child.Lucinda’s asthma is well controlled with a daily inhalation (morning) of Beclomethasone. When she has the occasional common cold, she also requires salbutamol to relieve her asthma symptoms.Three days after her mother developed a chest infection, Lucinda began to feel unwell. She became dyspnoeic within a day and had a temperature of 39.5 degrees Celsius. She wheezed and coughed and experienced bouts of chest tightness. Within a few hours her condition deteriorated, and her mother rushed her to the Emergency Department. A primary and secondary survey were done by the nurse practitioner together with the medical officer.They found the following:Vital signsRR: 32 bpm and shallowSpO2: 90% on room airBP: 160/90 mmHg (MAP 113 mmHg)HR 125 bpmTemp: 38.5 oCRespiratory assessmentLucinda was using her accessory muscles to help her breathe and on auscultation she had:decreased breath soundsabnormal breath sounds on inspiration and expirationShe was also having difficulties in completing sentences in one breath due to her dyspnoea. Venous blood gases:pHPvO2PvCO2Bicarbonate 30 mmol/L (ref range: 23 – 29mmol/L)7.29 (ref range: 7.31 – 7.41)25 mmHg (ref range: 30mmHg – 40mmHg) 55 mmHg (ref range: 41mmHg – 51mmHg)In the short time since Lucinda had arrived in the ED, her peripheral SpO2 saturation level had dropped further to 88%.Therapeutic interventionsThe nurse caring for her administered Salbutamol 0.5 mL with 3.0 mL normal saline through a nebuliser with oxygen for 10 minutes. The nurse also inserted an intravenous cannula in case Lucinda deteriorated further and required intravenous corticosteroids.Supplemental oxygen at 6L/min with humidification was administered. SpO2 target was 96%. Health Science Science Nursing CXA 240 Share QuestionEmailCopy link Comments (0)