A 38-year-old mildly obese woman is brought to the emergency departmentby her older sister with a se

A 38-year-old mildly obese woman is brought to the emergency departmentby her older sister with a severe asthma attack. The client has audible wheezes on inhalation and exhalation. Her admitting vital signs are blood pressure 172/100, pulse rate 114, respiratory rate 24, temperature 100 degrees Fahrenheit (38 degrees Celsius); oxygen saturation 78%. When the nurse asks her if she took any asthma medications today, she nods yes but is too breathless to speak. Her lips and nailbeds are cyanotic, and she has an anxious expression on her face. The nurse notes that the client has a brace around her right knee and a swollen right wrist. Her sister tells the nurse that the client called her about 30 minutes ago and asked to be taken to the hospital because several doses of her reliever inhaler within an hour was not helping her asthma attack, that in fact is was worsening, and that her husband refused to drive her. The sister goes on to say that the husband does not believe that asthma attacks are real and considers them only a way to get more attention even though the client has had asthma since childhood and has been taking prescribed asthma medications for years. The sister has all of the client’s prescribed medications in her purse, which include an albuterol inhaler, a salmeterol inhaler, and a fluticasone inhaler. When asked about the client’s obvious injuries, the sister reports that the client fell while walking the dog a week ago and has been taking both acetaminophen and an NSAID daily since then.  -What assessment information in this client situation is the most important and immediate concern for the nurse? (Hint: Identify the relevant information first to determine what is most important.) -What client conditions are consistent with the most relevant information? (Hint: Think about priority collaborative problems that support and contradict the information presented in this situation.)  -Which possibilities or explanations are most likely to be present in this client situation? Which possibilities or explanations are the most serious? (Hint: Consider all possibilities and determine their urgency and risk for this client.)  -What activities would most likely achieve the desired outcomes for this client? Which actions should be avoided or are potentially harmful? (Hint: Determine the desired outcomes first to decide which interventions are appropriate and those that should be avoided.)  -Which actions are the most appropriate and how should they be implemented? In what priority order should they be implemented? (Hint: Consider health teaching, documentation, requested health care provider orders or prescriptions, nursing skills, collaboration with or referral to health team members, etc.)  -What client assessment would indicate the nurse’s actions were effective? (Hint: Think about signs that would indicate an improvement, decline, or unchanged patient condition.)  Health Science Science Nursing NURSING 314 Share QuestionEmailCopy link Comments (0)

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