Case Study #4: Asthma: V ADMITTING HISTORY A 10-year-old girl is well known to the respiratory care protocol team. Over

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Case Study 4 Asthma V Admitting History A 10 Year Old Girl Is Well Known To The Respiratory Care Protocol Team Over 1 (54.3 KiB) Viewed 38 times

Case Study #4: Asthma: V ADMITTING HISTORY A 10-year-old girl is well known to the respiratory care protocol team. Over the past 8 years she was hospitalized for severe asthma three or four times per year. She averaged 2-to 3-day hospital stays per admission. Over the past 4 years she required mechanical ventilation three separate times. Because of her excessive absenteeism from school, the girl was held back in the second grade. At the time of this admission the patient was in the fourth grade. About 2 years ago the girl's mother lost her job as a teller at a local bank because of the many days she needed to take off from work to take her daughter to the doctor. For the past 15 months the mother has been able to work only part time as a checkout clerk at a local grocery store. This turn of events further compromised an already extensive and growing medical bill. The last time the patient was on a ventilator was about 2 years ago. After that hospitalization, her mother-a single parent-quit smoking, a habit she practiced for about 20 years, and gave away the family cat. In addition, the family's mobile home and its heating system were cleaned thoroughly, and several portable air-conditioning units were installed. For the past 6 months the girl has been on an albuterol inhaler four times a day and as needed; a beclomethasone inhaler four times a day, and oral theophylline twice daily Her mother was instructed in the proper way to monitor her daughter's peak expiratory flow rate (PEFRI regularly. The patient's personal best PEFR was about 290 L/min During a recent doctor's appointment, allergy skin tests turned up positive for ragweed and grasses. She was begun on a program of hyposensitization. Despite these efforts the girl still had a number of bad asthmatic episodes. Two episodes required hospitalization Mechanical ventilation was not required in either case.