Working under the supervision of a registered nurse and using the guidelines set out on page 16 and 17 of the module handbook  assess and plan Olayinka’s care in the A/E department.

Scenario 1

Olayinka, is a 23-year-old woman who has recently started university and is a known asthmatic. Olayinka normally manages her asthma and takes a salbutamol inhaler 1 or 2 puffs when needed. When living at home Olayinka’s mother would normally remind Olayinka of her inhaler and ensure she attends all her outpatient appointments. Over the past 48 hours Olayinka has developed a common cold and subsequent chesty cough, and notices her breathing is getting worse. Olayinka has not yet registered with a GP and as such has not renewed her inhaler prescription. Olayinka’s house mate became increasing worried about her and made the decision to call the university GP, who came immediately and reviewed Olayinka. The GP started Olayinka on a salbutamol nebuliser and rang an ambulance as her breathing was becoming increasing worse.

On arrival to A/E Olayinka’s observations were as follows: respiratory rate (RR) 28, Saturations 89% on room air, Heart Rate (HR) 110 beats per minute (Bpm), Blood Pressure 90/50 mmHg, and Temperature 38.0℃ and Chest x-ray was clear. Olayinka was commenced on back to back salbutamol 2.5 mg, and Atrovent 250mgs nebulisation with oxygen as the driver, oxygen 60%, IV hydrocortisone 50mgs, and Tazocin 4.5 mgs. Olayinka’s initially diagnosis was an asthma attack which appears to have developed because of acquiring the common cold.
PMHX
Asthmatic diagnosed as a child

Summative question / guidance

Working under the supervision of a registered nurse and using the guidelines set out on page 16 and 17 of the module handbook  assess and plan Olayinka’s care in the A/E department.

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