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  • Lower Respiratory Disorders Case Study Asthma

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    Elsayed Mohamed
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    Bradley, an 8-year-old boy, was brought to the emergency room for an acute asthmatic episode with coughing, wheezing, and breathlessness. He has a history of recurrent respiratory infections since infancy. On examination, he was using accessory muscles to breathe with widespread wheezing and decreased oxygen levels. Given his history and clinical signs, cystic fibrosis is suspected as the underlying cause in addition to his current respiratory infection exacerbating his condition. Management includes bronchodilators, chest physiotherapy, antibiotics if indicated, and ensuring proper nutrition, hydration, and home care education upon discharge.

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    Bradley, an 8-year-old boy, was brought to the emergency room for an acute asthmatic episode with coughing, wheezing, and breathlessness. He has a history of recurrent respiratory infections since infancy. On examination, he was using accessory muscles to breathe with widespread wheezing and decreased oxygen levels. Given his history and clinical signs, cystic fibrosis is suspected as the underlying cause in addition to his current respiratory infection exacerbating his condition. Management includes bronchodilators, chest physiotherapy, antibiotics if indicated, and ensuring proper nutrition, hydration, and home care education upon discharge.

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    © All Rights Reserved
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    27 views3 pages

    Lower Respiratory Disorders Case Study Asthma

    Uploaded by

    Elsayed Mohamed
    Bradley, an 8-year-old boy, was brought to the emergency room for an acute asthmatic episode with coughing, wheezing, and breathlessness. He has a history of recurrent respiratory infections since infancy. On examination, he was using accessory muscles to breathe with widespread wheezing and decreased oxygen levels. Given his history and clinical signs, cystic fibrosis is suspected as the underlying cause in addition to his current respiratory infection exacerbating his condition. Management includes bronchodilators, chest physiotherapy, antibiotics if indicated, and ensuring proper nutrition, hydration, and home care education upon discharge.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
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    Lower respiratory disorders case study

    History
    Bradley is a 8-year-old boy who is seen in the ER. He has coughs and wheezes
    frequently, several viral illnesses per year. First, and most severe episode, occurred
    when he was 7 months old. He has had many courses of antibiotics over the last few
    years for chest infections, also he has bulky, offensive stools. Now he is came with
    asthmatic episode. His mother reports that last time he was nearly transferred to the
    pediatric intensive care unit (PICU) with chest infection. He has developed a cold and
    become acutely breathless and physician prescribed salbutamol inhaler hourly but
    without much relief.

    Examination
    Bradley is sitting up in bed with a nebulizer in progress containing 5 mg salbutamol.
    His Oxygen saturation on 15 L of oxygen on arrival is documented as 89 per cent. He
    is quiet but able to answer questions with short sentences. His chest is hyper inflated
    (increased anteroposterior diameter) and he is using his accessory muscles of
    respiration. His respiratory rate is 60 breaths/min and he has marked intercostal and
    subcostal retraction. On auscultation there is equal but poor air entry with widespread
    expiratory wheeze. His temperature is 38.6_C. His pulse is 180 beats/min with good
    perfusion. He is small (height ninth centile, weight second centile), pale-looking,
    miserable and very dependent on his mother. He has finger clubbing. His abdomen is
    mildly distended but non-tender.

    Questions
    1. What is the most likely underlying cause for this acute episode?
    An:
    The respiratory infection and the recurrent of this infection is the most likely
    underlying cause for this acute episode.

    2. What is the likely underlying companying diagnosis based on the


    clinical presentation?
    An:
    Cystic Fibrosis
    3. What signs would you look for of impending respiratory failure?
    An:
    Shortness of breathing, tachypnea, cyanosis, confusion, tachycardia, nose
    flaring, retraction, sweating and wheezing.
    4. Outline your management plan for this acute episode
    An:
    Chest PT BID
    Medication
    Beta2 Agonist as bronchodilator
    D-Nase or Pulmozyme these decrease the viscosity of mucus
    Ibuprofen twice daily
    Exercise
    Early treatment of infections with antibiotics

    5. What should happen before he is discharged?


    Give teaching about the home care
    Teaching must be done with each discharge.
    CPT
    Providing breathing treatments
    Medication administration at home
    Some families will go home with nursing care to provide IV antibiotics at home.
    6. This child is in school age and needs to be cautioned regarding
    practicing exercise, explain this statement?
    The child should avoid exercise during the episode period and maintain clean,
    healthy environment and avoid dust and fumes as this may lead to infection
    again.
    7. Chest physiotherapy is applicable for child with asthma? And what its
    importance of it for the other diagnosis?
    An:
    Yes, it’s as it helps to remove and expel the mucus which was accumulated in
    the airway as this is the cause of the air trapping and the respiratory problem.

    8. How to maintain adequate growth and development for this child?


    An:
    Maintain the hydration and increase the fluid intake.
    Provide the appropriate nutritional intake for the child to maintain growth and
    development and increase high calorie intake and administer oxygen therapy
    to improve the respiratory function and increase SPO2

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