bluestar
Forum Guru
Topics: 236
Posts: 724
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of the case study of kaplan note on page 279.
A 26 y/o woman with a hx of asthma presents to ER with 3 days of progressive wheezing and shortness of breath after URI. She's taking inhaled albuterol and an OTC medication for her colds. Her respiratory rate is 28, pulse is 110, afebrile. Her right nasal turbinate is edimatous and erythematous, there's evidence of wheezing throughout the lung, but no crackles noted.
1), what's the treatment of choice?
a, B agonist inhaler
b, corticosteroid inhaler
c, aminophylline
2), what are the bad prognostic indicators? (I can't seem to find any?)
3), which of the ABGs is considered ominous for her?
a, 7.32/45/60
b, 7.45/30/50
4), 3 days later when you want to send her home, what's the drug regimen at this time?
a, B agonist inhaler
b, steorid inhaler
c, B agonist inhaler and steoid inhaler
5), 3 months later she comes for follow up. She needs documents of asthma for her work, what to do now? (PFT?) what medications is she likely to be taking now?
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| sanz
Forum Elite
Topics: 14
Posts: 154
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1. steroid inhaler to damp down the inflammation (her turbinates are eyrthematous)
2. Bad Px factors are when pt cant finish a sentence, using accessory mus to help breath, pulsus paradoxus, normaling pCO2 and no wheezes heard on auscultation.
3. 7.32/45/60 cuz she's getting acidotic
4. steroid and B agonist inhalers
5. I'm not so sure about this but she can have lung spirometry and PFTs done to assess how bad the damage is... Her drug would still be steroid and B agonist inhaler, unless her symtpoms worsens and in that case, add a long acting B agonist inhaler.
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