Question

Asthma Case Study Assignment History Ms. B is a 19-year-old competitive bronco rider seen in the emergency room because of shortness of breath. The dyspnea began during a particularly hard ride, which culminated in modest dust inhalation on the rodeo floor. She states that the tightness in her chest and shortness of breath were so severe that she had to eventually leave the rodeo and seek medical help. She is now very uncomfortable, even at rest. During the past week, she has had a cough productive of greenish-yellow sputum, mild fever, malaise, and fatigue, but she did not feel seriously ill until the onset of dyspnea at the rodeo earlier in the day. She denies previous lung problems except for mild "wheezing" in her chest, which has occurred off and on during the past several years. She denies the use of any prescription medications or any previous episodes of dyspnea, chest pain, leg pain, hemoptysis, sinusitis, or allergies. Her family history is negative for lung disease. Physical Examination General: 19-year-old, 66 inches tall, and 140 lbs. Patient alert but restless and in moderate respiratory distress, mildly diaphoretic, sitting up on the edge of the bed leaning forward with her arms braced on her knees; cough frequent and productive of small amounts of greenish sputum. Vital Signs: Temperature 101.1 F, Respiratory Rate 38/min, Blood Pressure 170/95 mmHg, Heart Rate 140/min, Paradoxical Pulse 25 mmHg. HEENT: Sinuses not tender to palpation; nasal flaring with inspiration. Neck: Trachea midline and mobile to palpation; no stridor; carotid pulsations ++ and symmetrical bilaterally with no bruit; no lymphadenopathy, thyroidomegaly, or jugular venous distention; sternocleidomastoid muscles tensed during inspiration. Chest: Increased anteroposterior diameter with decreased expansion during breathing and mild abdominal paradox with respiratory efforts. Lungs: Rapid respiratory rate with prolonged expiratory phase and polyphonic wheezing heard over the entire chest during inhalation and exhalation. Heart: Regular rhythm at 140/min; no murmurs, gallops, or rubs; point of maximum impulse in normal position. Abdomen: Soft, nontender; bowel sounds present; no masses or organomegaly. Extremities: No clubbing, cyanosis, or edema; pulses ++ and symmetrical in all areas. Questions: What infection control guidelines would you institute for this patient? List all of the protective gear you would use and state the rationale for your decision.

Asthma Case Study Assignment

History
Ms. B is a 19-year-old competitive bronco rider seen in the emergency room because of shortness of breath. The dyspnea began during a particularly hard ride, which culminated in modest dust inhalation on the rodeo floor. She states that the tightness in her chest and shortness of breath were so severe that she had to eventually leave the rodeo and seek medical help. She is now very uncomfortable, even at rest. During the past week, she has had a cough productive of greenish-yellow sputum, mild fever, malaise, and fatigue, but she did not feel seriously ill until the onset of dyspnea at the rodeo earlier in the day. She denies previous lung problems except for mild "wheezing" in her chest, which has occurred off and on during the past several years. She denies the use of any prescription medications or any previous episodes of dyspnea, chest pain, leg pain, hemoptysis, sinusitis, or allergies. Her family history is negative for lung disease.

Physical Examination
General: 19-year-old, 66 inches tall, and 140 lbs. Patient alert but restless and in moderate respiratory distress, mildly diaphoretic, sitting up on the edge of the bed leaning forward with her arms braced on her knees; cough frequent and productive of small amounts of greenish sputum.
Vital Signs:
Temperature 101.1 F, Respiratory Rate 38/min, Blood Pressure 170/95 mmHg, Heart Rate 140/min, Paradoxical Pulse 25 mmHg.
HEENT: Sinuses not tender to palpation; nasal flaring with inspiration.
Neck: Trachea midline and mobile to palpation; no stridor; carotid pulsations ++ and symmetrical bilaterally with no bruit; no lymphadenopathy, thyroidomegaly, or jugular venous distention; sternocleidomastoid muscles tensed during inspiration.
Chest: Increased anteroposterior diameter with decreased expansion during breathing and mild abdominal paradox with respiratory efforts.
Lungs: Rapid respiratory rate with prolonged expiratory phase and polyphonic wheezing heard over the entire chest during inhalation and exhalation.
Heart: Regular rhythm at 140/min; no murmurs, gallops, or rubs; point of maximum impulse in normal position.
Abdomen: Soft, nontender; bowel sounds present; no masses or organomegaly.
Extremities: No clubbing, cyanosis, or edema; pulses ++ and symmetrical in all areas.

Questions:
What infection control guidelines would you institute for this patient?
List all of the protective gear you would use and state the rationale for your decision.

Added by Melvin S.

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