Wednesday, July 24, 2019

WITH REFERENCE TO NATIONAL ASTHMA GUIDELINES, DISCUSS THE IMMEDIATE Essay

WITH REFERENCE TO NATIONAL ASTHMA GUIDELINES, DISCUSS THE IMMEDIATE TRETAMENT OPTIONS AND LONGER TERM ISSUES FOR A 15 YEAR OLD FEMALE PRESENTING WITH AN ACUTE A - Essay Example Once the wheezing is controlled and the patient is brought home from the hospital, she must have follow up visits on a regular basis in order to minotor her condition. Since Jane has been admitted on an emergency basis with severe difficulty in breathing, the first step is to dilate the airways. The lack of oxygen can be corrected through the use of high concentrations of inspired oxygen (40-60%) using a high flow mask such as the Hudson mask(BTS:6.3.1). ABG and PEF levels must be maintained at above 92% and 50% respectively. If PEF levels are not rising fast enough, continuous nebulisation may also be considered using B2 agonists (BTS:6.3.2). To provide instant relief in breathing the use of ipratropium in association with salbutamol or terbutaline may also be considered. This helps to release blocked airways and bring the asthma attack under control(Plotnick and Duchrame 2003). The combination of ipratropium with salbutamol or tetrabuline works faster since they go straight to the lungs (National Institute 2001:1-13). Once Jane is stabilized and out of the hospital, there is no need to continue the use of ipratropium, since it will not be beneficial. (Stoodley et al 1999:8-18). The main aim of the long term treatment is to bring some measure of control over the wheezing attacks, so that Jane can sleep well at night and engage in moderate levels of activity without getting an attack. Since anxiety also brings about an attack, the aim of long term treatment must be to provide a supportive psychological environment for Jane, so that she does not get easily stressed. Jane must be reassured that her condition is curable, even though she has had it for so long. Because of her long history with asthma, Jane is likely to consider herself as a sick child who cannot play or be active. But she must first be counseled that she can also lead a fairly normal life, with a proper regimen of

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