NUR 502 Module 3 Discussion: Pulmonary Function

NUR 502 Module 3 Discussion: Pulmonary Function

Pulmonary Function

According to the case study information, how would you classify the severity of D.R. asthma attack?

I would classify DR’s asthma attack as a persistent moderate asthma attack. The symptoms occur daily, with nighttime awakenings, and reduced lung function (60-80%) (Bagnasco et al., 2021).

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.

The most common asthma triggers in any patient include exposure to indoor and outdoor allergens such as mold, mites, dander, pollen, and mold. The other triggers include stress such as strenuous physical exercise and exposure to extreme weather conditions (Côté et al., 2020). Indoor or outdoor triggers apply to DR due to his presenting symptoms such as stuffy nose and watery eyes. The symptoms imply that he also has allergic rhinitis due to the presence of post-nasal drainage. Therefore, indoor and outdoor triggers are the primary causes of his asthma attack.

Based on your knowledge and your research, please explain the factors that might be the etiology of D.R. being an asthmatic patient.

The factors that might be the etiology of DR being an asthmatic patient are varied. Firstly, a history of allergies could contribute to his asthma. Asthma is an allergic reaction to an allergen. The other risk factor is race or ethnicity. Puerto Ricans and African Americans have a higher risk of asthma as compared to other races. Sex is the other factor since asthma is more common in males than females (Sockrider & Fussner, 2020). DR’s occupation is also another factor since regular exposure to chemicals or industrial dust increases the risk of asthma. DR is likely to develop asthma if he works in an environment where he is constantly exposed to chemicals and dust.

References

Bagnasco, D., Paggiaro, P., Latorre, M., Folli, C., Testino, E., Bassi, A., Milanese, M., Heffler, E., Manfredi, A., Riccio, A. M., De Ferrari, L., Blasi, F., Canevari, R. F., Canonica, G. W., Passalacqua, G., Guarnieri, G., Patella, V., Maria Pia, F. B., Carpagnano, G. E., … Lo Cicero, S. (2021). Severe asthma: One disease and multiple definitions. World Allergy Organization Journal, 14(11), 100606. https://doi.org/10.1016/j.waojou.2021.100606

Côté, A., Godbout, K., & Boulet, L.-P. (2020). The management of severe asthma in 2020. Biochemical Pharmacology, 179, 114112. https://doi.org/10.1016/j.bcp.2020.114112

Sockrider, M., & Fussner, L. (2020). What Is Asthma? American Journal of Respiratory and Critical Care Medicine, 202(9), P25–P26. https://doi.org/10.1164/rccm.2029P25

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Fluid, Electrolyte, and Acid-Base Homeostasis

Based on Ms. Brown admission’s laboratory values, could you determine what type of water and electrolyte imbalance does she has?

Ms. Brown has hypernatremia, hyperkalemia, and hyperchloremia.

Describe the signs and symptoms to the different types of water imbalance and described the clinical manifestation she might exhibit with the potassium level she has.

The different signs and symptoms of hyperkalemia Ms. Brown has include muscle weakness, nausea, numbness, tingling, chest pain, palpitations, irregular heartbeats, diarrhea, abdominal pain, nausea, and vomiting. The clinical manifestations that might be discovered include cardiac arrhythmias, cardiac conduction abnormalities such as tall T waves, muscle weakness, and muscle paralysis (Brown & Paloian, 2023).

In the specific case presented which would be the most appropriate treatment for Ms. Brown and why?

The appropriate treatment for Ms. Brown would be the administration of insulin and sodium or calcium bicarbonate combination. This treatment will lower the blood glucose level while shifting potassium into the cells and prevent acidosis. Ms. Brown has hyperglycemia with electrolyte imbalances that include hyperkalemia, hypernatremia, and hyperchloremia. She is at risk of developing acidosis due to elevated blood glucose levels and electrolyte imbalances (Palmer et al., 2021). Therefore, insulin administration with glucose, sodium, or calcium combination is appropriate to shunt potassium to the cells while lowering the blood glucose level simultaneously.

What the ABGs from Ms. Brown indicate regarding her acid-base imbalance?

Ms. Brown has metabolic acidosis.

Based on your readings and your research define and describe Anion Gaps and its clinical significance.

Anion gap refers to the difference between positively and negatively charged electrolytes in the blood. The anion gap helps determine if the blood is acidic or basic. The gap also helps diagnose patients with electrolyte imbalances in the body. Healthcare providers use the knowledge of the anion gap to determine the patient’s risk of developing health problems such as diabetic ketoacidosis in case of metabolic acidosis. The anion gap also helps determine the body’s ability to handle, metabolize, and eliminate toxic wastes. For example, hyperkalemia might be associated with health problems such as decreased renal clearance of electrolytes from the body (Pandey & Sharma, 2023). Therefore, the anion gap guides the diagnosis, management, and monitoring of fluid and electrolyte disorders.

References

Brown, D. H., & Paloian, N. J. (2023). Hypokalemia/Hyperkalemia and Hyponatremia/Hypernatremia. Pediatrics In Review, 44(7), 349–362. https://doi.org/10.1542/pir.2021-005119

Palmer, B. F., Carrero, J. J., Clegg, D. J., Colbert, G. B., Emmett, M., Fishbane, S., Hain, D. J., Lerma, E., Onuigbo, M., Rastogi, A., Roger, S. D., Spinowitz, B. S., & Weir, M. R. (2021). Clinical Management of Hyperkalemia. Mayo Clinic Proceedings, 96(3), 744–762. https://doi.org/10.1016/j.mayocp.2020.06.014

Pandey, D. G., & Sharma, S. (2023). Biochemistry, Anion Gap. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK539757/

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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

1. According to the case study information, how would you classify the severity of D.R. asthma attack?
2. 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.
3. Based on your knowledge and your research, please explain the factors that might be the etiology of D.R. being an asthmatic patient.

Fluid, Electrolyte and Acid-Base Homeostasis:
Ms. Brown is a 70-year-old woman with type 2 diabetes mellitus who has been too ill to get out of bed for 2 days. She has had a severe cough and has been unable to eat or drink during this time. On admission, her laboratory values show the following:

• Serum glucose 412 mg/dL
• Serum sodium (Na+) 156 mEq/L
• Serum potassium (K+) 5.6 mEq/L
• Serum chloride (Cl–) 115 mEq/L
• Arterial blood gases (ABGs): pH 7.30; PaCO2 32 mmHg; PaO2 70 mmHg; HCO3– 20 mEq/L

Case Study Questions

1. Based on Ms. Brown admission’s laboratory values, could you determine what type of water and electrolyte imbalance does she has?
2. Describe the signs and symptoms to the different types of water imbalance and described clinical manifestation she might exhibit with the potassium level she has.
3. In the specific case presented which would be the most appropriate treatment for Ms. Brown and why?
4. What the ABGs from Ms. Brown indicate regarding her acid-base imbalance?
5. Based on your readings and your research define and describe Anion Gaps and its clinical significance.

Submission Instructions:

• You must complete both case studies

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
• All replies must be constructive and use literature. MUST be done on a SEPARATE day from the initial post.
• Please post your initial post by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
• You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.

Grading Rubric

Your assignment will be graded according to the grading rubric.