TinaBremmeris a 20-year-old collegestudentwithmoderatepersistentasthma. Shehas a cold. Whiledashingacrossthecampuson a coldfallday, shesuffersanasthmaattack. Hergirlfriend, whoiswithher, knowsthatTinakeepshermedicationinherbackpack. SheopensTina’spack, findsaninhaler, andgivesittoher. Tinausestheinhaler, butinsteadofachievingrelief, shegoesintobronchospasm. Sheistakentotheemergencyroomofthenearesthospital. Dataobtainedfromthenursingassessmentincludethefollowing: • Lungsoundshavebilateralwheezes, withdiminishedsoundsatbases • Pulseoximetry 92% onadmissiontothe ER • Otherphysicalassessmentnormal • Vitalsigns: temperature, 97.7°F; pulse, 110; respirations, 26 andshallow; bloodpressure, 120/86 Thepatientiscurrentlyonmedicationsthatincludealbuterolinhaler, twopuffs q4h prn, andflunisolideoralinhalant, 2 puffsbideveryday. CaseStudyQuestions 1. ProvidetherationaleforwhyMs. Bremmerisprescribedtheseinhalers. (10 pts) 2. WhatcontraindicationsorprecautionswouldeliminatetheuseofthesedrugsforMs. Bremmer?(5 pts) 3. WhatpatientvariablesaremostimportanttoconsiderforMs. Bremmerwhenassessingherdrugtherapy?(5 pts) 4. Whataspectsofcoredrugknowledge (pharmacotherapeutics, pharmacokinetics, andpharmacodynamics) areespeciallyrelevanttoconsiderbecausetheymayinteractwiththepatientvariables?(5 pts) 5. Whichofthefindingsfromthenursingassessmentdemonstratetheeffectivenessofdrugtherapy? (5 pts) 6. Whichofthefindingsfromthenursingassessmentdemonstratepossibleadverseeffectsfromthedrug therapy?(5 pts) 7. Whatnursingactionsareindicatedtomaximizetherapeuticeffects?(5 pts) 8. Whatnursingactionsareindicatedtominimizeadverseeffects?(5 pts) 9. WhatteachingisrequiredforMs. Bremmerregardingherdrugtherapy? Includelistofanyadditionaldataneededtodetermineappropriateteaching. (5 pts)
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