Question

Concept Map: Asthma Mark Norse, a 22-year-old man, who lives in a small mountain town in Colorado, is highly allergic to dust and pollen. Anxiety seems to play a role in exacerbating (triggering) his asthma attacks. Mr. Norse's wife drove him to the clinic this morning when his wheezing worsened and did not respond to belclomethosone (Vanceril) and ipratropium bromide (Atrovent) inhalers. Upon arrival his vital signs are B/P 152/84, P 124, R 42, T. 100.4. You start Mr. Norse on 02 4L/min via nasal cannula and an IV of D/5W at a KVO rate of 40gtts/hour. His ABG's are pH 7.31, CO2 26, HCO3 26 and O2 sats at 88%

Answer 1

13) 6 mistakes made by the patient while administering this medication are :-

• Inhaling medication too fast and lips not closed completely around the spacer or inhaler.
• Holding the aerosolizer at an angle pointing towards his cheek in front of his mouth which may result in the medication sticking to the cheek.
• Taking deep breath while squeezing the canister and not holding his breath for few seconds after the inhalation of medication.
• Holding his head too far forward or backward and not using the spacer.
• Not breathing out fully before using the inhaler.
• Vigorously shaking the canister.

14) The benefit of a spacer being used by this patient is that it helps the medicine to reach the airways instead of remaining in the mouth. It acts as a chamber between the mouth and canister. It avoids the coordination of several actions and timing issues related with the administration of the medication. Spacer also slows down the speed of the drug coming from the inhaler.