sthma Case Study 16 year old Ben is seen in the emergency room for the complaint of “difficulty breathing”.

sthma Case Study 16 year old Ben is seen in the emergency room for the complaint of “difficulty breathing”. He could not get enough air to speak in complete sentences. During your initial assessment, he states he has been short of breath for the last week and it has progressively gotten worse. His has a history of asthma, and says he has been using his inhaler. Ben was asked to inhale as deeply as possible and then blow out as hard and as quickly as possible into a peak flow meter. Ben’s peak flow measured 150 ml/L, about 25% of his personal best peak flow of 600 ml/L. Lungs assessment reveals bilateral wheezing, rate in the mid 20s. Respiratory sees patient and gives a HHN treatment of Albuteral/Atrovent 02 sats are 92%. Patient seems anxious. VS- Afebrile; 150/70; Pulse = 120. ABGs PH 7.35 PCO2 47 PO2 80 Bicarb 24 Physician orders another nebulizer, steroids, and O2, however after 2 hours does not improve. Patient is having some nasal flaring and has some accessory muscle use while breathing. Physician orders BiPap setting of 10/5 and then advances to 12/6. Blood gasses are redrawn and are 7.20/64/75/24. He is awake, alert,

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