Respiratory Case Study Tanisha Robinson, a 14-year-old female, has been seen regularly in the clinic for chronic asthma. Today, Tanisha’s mother has accompanied her for a checkup. Tanisha has required two visits to the emergency room (ER) for severe wheezing in the month since her last clinic visit.The physical assessment revealed that the patient was in no distress and breath sounds were clear. Her vital signs were BP 126/82P 84RR 20. Her skin was warm, dry, and pink in color. Tanisha could speak clearly and seemed relaxed.During the interview, the nurse learned that the patient has been following her prescribed treatments and has done well except for the two ER visits.The nurse learned that each ER visit occurred after school hours. The patient experienced severe shortness of breath and wheezing that was unrelieved by rest or use of her inhalers. ER treatment consisted of injection of epinephrine, administration of oxygen, intravenous (IV) fluids,Benadryl, and steroids. Each ER visit lasted approximately 6 hours. The patient’s breathing was restored to nearly normal at discharge and she was given a prescription for a course of prednisone.When asked if she could identify any precipitating factors, Tanisha replied, “I know they happened on days that we had gym, but I don’t usually have a problem with that.” The nurse asked if she had any changes in her routines, activities, or environments. She said, “No, not that I can think of.” Her mother stated, “We’re so upset. She’s been out twice this month.” The patient then added, “Yes, I hate to have to miss school and get behind and now my friend and I have to work twice as hard as before to get our project done.”The nurse asked about the project and the patient said, “We are working on an art project collecting materials and doing a thing on textures. It’s pretty cool. We collected old clothes from the Salvation Army and a garage sale and we’ve been cutting them up sort of in a collage.” The nurse asked if the work on the project coincided with her recent attacks. The patient said, “Gee, I don’t know, I never thought about it.” Her mother stated, “Oh, we never even thought about that, but on both days, she had been working on the project after school with her friend and really got bad as the evening wore on.”Use APA sources to:Describe the nurse’s thoughts and actions as the nurse applies the steps of the critical-thinking process in this situation.In interpreting the data, what could be contributing to her symptoms?What are the treatment options that could be developed for this 14-year-old and her mother?Which of the Healthy People 2020 objectives are important to this patient and her care?What special considerations should the nurse pay attention to in this situation? Health Science Science Nursing NUR 123 Share QuestionEmailCopy link Comments (0)
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