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Case Study 3

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by

Esmeralda Tonche

on 12 November 2015

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Transcript of Case Study 3

THE PRIMARY GOAL OF ASTHMA MANAGEMENT IS TO ELIMINATE AS MANY TRIGGERS AS POSSIBLE!
The Hospital
Barbara's Vitals
BPM:95
Blood pressure: 90/58
BR: 20;labored
Experience pain in chest,left arm, and neck, cold hands, labored breaths and wheezing

Capillary
Filtration: fluid movement out of capillary.
Reabsorption: fluid movement into capillary.
Hydrostatic pressure (BP): Push force
Osmotic Pressure: Pull force
The blood pressure and water pressure are responsible for balancing and creating the movement of fluid across the capillary wall.
Asthma attack to a Heart Attack
During an asthma attack there is no sufficient air entering the lungs which affects the heart
Then creates stress and releases adrenaline which causes heart rate to rise
pressure in the lungs makes it difficult for blood to pass by the capillaries to be oxygenated. In which then blocks the right ventricle, and unfortunately, also the left atrium.
If the asthma attack is not treated right away then there would be a rise in pulse and a decrease in blood pressure ( since there is not enough blood reaching left side of heart)
Case Study 3

Vital signs normal ranges for adults
BP: 90/60-139-89 mm Hg
HR:55-90 bpm
Respiration:16-24 per min
Temp- 97.6-99 degrees Fahrenheit
Asthma symptoms from heart problems
Wheezing
Difficulty breathing
Fast heart rate
Factors that can trigger an asthmatic episode are exercise, allergies, stress, drugs, smoking, air pollution, and extreme temperatures.
During an asthmatic episode the linings of the airways become swollen and the muscles tighten, causing the airway to tighten.
7. Why is wheezing usually worse when asthmatics exhale?
Why is airflow restricted during an asthmatic episode?
What factors can trigger an asthmatic episode?
Which of the airways do not contain rings of cartilage, and are therefore
more likely to collapse?
Exhalation creates pressure in the lungs which causes the bronchioles to constrict. Inhalation relieves the pressure, which is why inhalation is easier.
That Night
Is this a bad asthma attack?
No. barb has heart attack like symptoms like like pain in her chest, neck and left arm. she also had a fast breathing rate and a pale look to her. the fast breathing can be a symptom of asthma but since the nebulizer didnt help it points to a heart attack. this couldve brought on an asthma attack
What couldve have brought on the episode?
-cat hiar
-fatigue
-possible heart attack
What symptoms indicate she has something?
-Her fast breathing
-Pain in her chest, neck, and left arm
-Fatigue
-Paleness
Speculation on barbs condition
With all the signs she is exhibiting i think she is having a heart attack with a asthma attack.
CT scan and ultrasound of barbs legs
CT scans can be used to check abnormalities that an ultrasound has detected
An ultrasound of her legs can show something what a typical xray cant and help solve why her legs are more swollen then usual.
Re- speculate on barbs condition?
Bronchiole structures control airflow and do not have rings of cartilage. However, they do have smooth muscle and elastin in their walls that control bronchiole diameter.
A heart attack seems less likely with the blood results but still a possibility. Now i think it is something that is affecting her breathing, other than asthma. it could be pulmonary obstruction
If the pressure exerted exceeds the pressure with the respiratory bronchioles, then they will collapse.
Tests
Barbara, John’s Wife was admitted to the hospital to run several tests after hip replacement surgery. The test that were conducted are Radioactive tracers, Ventilation quantification scan and Spiral CT scan.


Radioactive Tracers
Ventilation Quantification Scan
Spiral Computed Tomography Scan
A radioactive tracer, also called a radioactive label, is a substance containing a radioisotope that is used to measure the speed of chemical processes and to track the movement of a substance through a natural system such as a cell or tissue
Ventilation Quantification Scan is a type of medical imaging using medical isotopes to evaluate the circulation of air and blood within a patient's lungs in order to determine the ventilation/perfusion ratio. The ventilation part of the test looks at the ability of air to reach all parts of the lungs, while the perfusion part evaluates how well blood circulates within the lungs.
This test is most commonly done in order to check for the presence of a blood clot or abnormal blood flow inside the lungs.
Spiral Computed Tomography scan – a procedure that uses a computer linked to an x-ray machine to make a series of detailed pictures of areas inside the body.

Conclusion
After several tests were performed, Barbara’s health charts concludes that are blood pressure, arterial PO2, arterial PCO2, blood pH, blood creatine phosphokinase, nanograms, blood troponin I, breathing rate, breathing sounds and asthmatic levels fall below or above normal values.
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