BRONCHIAL ASTHMA

Name: Roopchand Reshmi

Cohort: 5th august 2013
Trainee Nurse
Posting: Victoria Hospital

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 Acknowledgement
I would like to thanks Mrs. Anita for giving me the opportunity
to take her as my subject for my case study. She has been very
helpful throughout my process. I would also like to thanks Mrs.
Jagatpal for guiding me. A special thanks to the ward manager
and the nursing staff for their support towards my case study.
Without these people my case study would not have been
possible.

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 Table of content
Acknowledgement
Introduction
Profile of patient
Medical management
Investigation
Nursing care plan
 Assessment
 Diagnosis
 Interventions
 Rationale
Evaluation
Health education
References

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 Introduction

Bronchial asthma is the common asthma which is

an inflammatory disease of airways that causes
periodic attacks of coughing, wheezing,
breathlessness and chest congestion. Due to the
inflammation of airways, a person feels difficulty in
breathing and chest tightness. Some people feel
these conditions at night which is called nocturnal
asthma or in the early morning. Asthma is thought
to be caused by a grouping of genetic and
environmental factors. Environmental factors
include contact to air pollution and allergens. Other
potential triggers include medications such as
aspirin and beta blockers.

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 Profile of patient
Name: Anita (fictious)
Sex: female
Age: 43years
Status: married and has two daughters
Address: Glen Park Vacoas
Job: home assisstant carer
History: asthma since the age of 10
Date of admission: 10 october 2016

Case presentation
During the past few days Anita was suffering from
shortness of breath, coughing and wheezing. On
attending the accidental and emergency
department, she was having difficulty in breathing
and was immediately seen by the casualty officer.
she was nebulised with Ventolin and intravenous
injection of hydrocortisone was given. Chest X ray
and ECG also was done. Both investigations were
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normal. Blood pressure was 140/90, Gr: 6.5mmol/l,
temperature: 36.5 degree c and SPO2: 95%. Despite
all these treatments, Anita was not relieved.
She was then admitted to female ward 4 at Victoria
Hospital.

Medical management

IV normal saline 1 pint 8 hourly

Nebulise with atrovent 0.5mg and Ventolin 5mg 6 hourly/ PRN
IV solumedrol 40mg BD
Tab augmentin 1g TDS

Investigations

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Chest x ray
ECG
Blood test: U/E, S. Creatinine, FBC

Nursing care plan

Nursing Nursing Nursing rationale
assessment diagnosis intervention
 Moaning Pain Provide rest periods Increasing one’s
 Sleeplessness to promote relief, concentration, these
 irritable sleep and relaxation. techniques help an
individual to
Distraction techniques decrease the pain
such as calm music experience.
and reading books.

Provide analgesics as
prescribed by doctor.
 Wheezing Chest tightness Keep patient Keeps secretion
 Shortness of adequately hydrated. moist and easier to
breath expectorate.
 coughing Teach and encourage
patient to use deep Helps to improve
breathing exercise ventilation and
and coughing mobilize secretions
exercise. without causing
breathlessness and

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 Instruct patient to fatigue.
avoid bronchial
irritants such as It causes
cigarette smoke and bronchoconstrictions
fumes. and increase mucus
production, which
Administer then interferes with
nebulisation as airway clearance.
ordered
It ensures adequate
delivery of
medications.
 Poor impulse anxiety Maintain a calm, non Anxiety is contagious.
control threatening manner Hence patient
 Feeling of while working with develops feeling of
discomfort patient. security in presence
of calm nursing staff.
Establish and maintain Therapeutic skills
a trusting relationship need to be directed
with patient by towards the patient
listening to her, and patient needs to
answering questions feel at ease as the
directly, being nurse may be a
available and respect threat to the patient.
patient’s use of
personal space. Patient’s safety is
utmost priority. Being
Remain with patient with the patient will
at all the time when make her feel at
levels of anxiety are ease.
high.

Reassure patient of
his safety and
security.

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  Restlessness fatigue
 Inability to cope
with daily
routine activity
Evaluate adequacy of Patient will be able to
nutrition and sleep. identify factors that
aggravate and
Encourage patient to relieved her fatigue.
get adequate rest.

Encourage patient to
express feeling about
fatigue, use active
listening techniques.

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 Evaluation
Patient is feeling more comfortable with the nursing care that
was provided to her at ward level. No pain is diagnosed and
patient is now being able to breathe properly without any
wheezing sound. Patient was then discharged on 14 october
2016.
Patient was advice to take the following medications:
Ventolin inhaler 2 puff BD
Becloasthma 2 puff BD for 1 month then 2 puff OD for 1 month
Tab prednisolone: 30mg for 3 days
20mg for 3 days
10mg for 3 days

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 Health education
 Minimize dust that may trigger your asthma.
 Use washable curtains and blinds.
 Avoid keeping pets as you may be allergic with fur or
feathers.
 Clean your house regularly. While cleaning wear face mask
to prevent allergies from dust.
 Get regular exercise. Regular exercise can strengthen the
heart and lung, it helps relieve asthma symptoms.
 In cold temperature, wear a mask to warm the air that you
are breathing.
 Breathing exercise may reduce the amount of medication
you need to keep asthma symptoms under control.
 Attend your appointment regularly and discuss any
difficulty with your doctor.
 Techniques of using the inhaler:
 Take the cap off the inhaler and the spacer.
 Shake the inhaler well.
 Attach the spacer to the inhaler.
 Breathe out gently to empty your lungs.
 Put the spacer between your teeth and close
your lips tightly around it.
 Keep your chin up.
 Spray 1 puff into the spacer by pressing down on
the inhaler.
 Breathe in slowly. Breathe as deep as you can.

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  Take the spacer out of your mouth.
 Hold your breath as you count to 10, if you can.
 Gather your lips and slowly breathe out through
your mouth.
 After using your inhaler, rinse your mouth with
water, gargle, and spit. This helps reduce the
side effects from your medicine.

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 Referencing
http://www.mayoclinic.org/diseases-conditions/
asthma/basics/treatment/con-20026992
https://medlineplus.gov/ency/patientinstructions/
000042.htm
http://nurseslabs.com
http://www.mayoclinic.org/diseases-conditions/
asthma/basics/prevention/con-20026992
Words: 954

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