Pulmonary Function
Pulmonary Function:
D.R. is a 27-year-old man, who presents to the nurse practitioner at the Family Care Clinic complaining of increasing SOB, wheezing, fatigue, cough, stuffy nose, watery eyes, and postnasal drainage—all of which began four days ago. Three days ago, he began monitoring his peak flow rates several times a day. His peak flow rates have ranged from 65-70% of his regular baseline with nighttime symptoms for 3 nights on the last week and often have been at the lower limit of that range in the morning. Three days ago, he also began to self-treat with frequent albuterol nebulizer therapy. He reports that usually his albuterol inhaler provides him with relief from his asthma symptoms, but this is no longer enough treatment for this asthmatic episode.
Case Study Questions
According to the case study information, how would you classify the severity of D.R. asthma attack?
Name the most common triggers for asthma in any given patients and specify in your answer which ones you consider applied to D.R. on the case study.
Based on your knowledge and your research, please explain the factors that might be the etiology of D.R. being an asthmatic patient.
Sample Solution
Assessment of D.R.'s Asthma Attack Severity:
Based on the case study information, D.R.'s asthma attack can be classified as moderate to severe. Here's why:
- Symptoms: His increasing shortness of breath, wheezing, fatigue, cough, and persistent nasal symptoms indicate a significant exacerbation of his asthma.
- Peak flow rates: Consistently low peak flow rates (65-70% of baseline) suggest impaired lung function and airflow limitation.
- Nocturnal symptoms: Nighttime asthma symptoms for three nights are a sign of a more severe attack.
- Limited response to albuterol: The usual effectiveness of his albuterol inhaler no longer providing relief further indicates a worsening attack.
Full Answer Section
- Frequent nebulizer use: His need for frequent nebulizer therapy with albuterol is another indicator of moderate to severe exacerbation.
- Environmental allergens: Dust mites, pollen, mold, pet dander, and insect stings.
- Air irritants: Smoke, air pollution, strong odors, and cold air.
- Respiratory infections: Common colds, flu, and sinusitis can trigger asthma attacks.
- Exercise-induced asthma: Physical exertion can trigger asthma in some individuals.
- Emotional stress: Anxiety, fear, and anger can worsen asthma symptoms.
- Certain medications: Aspirin, beta-blockers, and nonsteroidal anti-inflammatory drugs (NSAIDs) can trigger asthma in some people.
- Upper respiratory infection: The recent onset of stuffy nose, watery eyes, and postnasal drainage suggests a possible upper respiratory infection, which can be a common trigger for asthma attacks.
- Environmental allergens: It's difficult to say without further information, but depending on the season and D.R.'s environment, exposure to allergens like pollen or mold could be contributing to his symptoms.
- Stress: While not mentioned in the case study, increased stress levels could be a factor, especially if he's facing any work or personal challenges.
- Genetics: A family history of asthma significantly increases the risk.
- Early-life exposures: Exposure to smoke, pollution, or allergens during childhood can increase the risk.
- Immune system factors: Certain immune system responses may play a role in asthma development.
- Socioeconomic factors: Lack of access to healthcare and environmental risks in disadvantaged communities can contribute to higher asthma rates.