Order ID |
53563633773 |
Type |
Essay |
Writer Level |
Masters |
Style |
APA |
Sources/References |
4 |
Perfect Number of Pages to Order |
5-10 Pages |
Description/Paper Instructions
Assignment of Respiratory Case Study
Study of respiratory cases:
Scenario: BF, the 31-year old man living in a small mountain city in Western Virginia, is very allergic to pollen and dust and has a slight asthma history. The wife of BF drove him to the emergency hospital because he had not reacted to his fluticasone/salmeterol (Advair) inhaler, could not lie down, and started using accessory muscles. The BF is begun immediately at 75 mL/h by nasal cannula and intravenous (IV) D5W with 4L of oxygen. The laboratory receives a set of blood arterial gasses (ABG). BF seems worried and says he’s breathless.
Chart:
Signs vital:
152/84 BP
124 bpm pulse
42 breaths/min Resp rate
100.® F Temp 100.
Topics for discussion:
1. What is the justification for starting BF immediately on oxygen?
2. With the history of BF and the presentation of complaints in mind, what are the most significant areas that you need to address during your physical evaluation?
Chart:
ABGs
7.31 pH
Paco2 48 Paco2
HCO3 26 HCO3
Paolo2 55
Chart:
Orders for medication:
2.5 mg Albuterol with ipratropium 250 mcg Nebulizer Statistics
Inhalation of albuterol (Ventolin) 2 puffs in 4 hours
0.4 percent Nebulizer therapy q3hrs Metaproterenol sulfate (Alupent)
MDI: 220mcg, 1 puff twice daily Fluticasone (Flovent HFA)
3. What are the reasons for STAT (immediately) with albuterol 2.5 mg with ipratropium 250 mcg nebulizer?
4. Indicate the classification of drugs and expected results of use of metaproterenol sulfate (Alupent) and fluticasone BF should (Flovent).
You examine BF and find that in all lung fields with non-productive toxins and accessory muscle use, lung sounds with inspiratory and expiratory wheezing have been reduced. He has pale, warm, and dry skin. The ECG displays ectopic sinus tachycardia. He is alert and x4-sphere oriented. He appears worried, sits straight, leans over the bedside table, and continues to complain about breathlessness.
5. What is your primary care aim now? 5.
6. For the next three hours, you will have to observe BF closely. What is the most dangerous complication?
7. Identify four symptoms and indicators of this problem for which you will evaluate in BF.
8. If combination inhalation aerosols are provided with no explicit sequencing instructions, you must be aware of the safe drug administration standards. Describe the correct sequence for BF therapy.
9. What are your aerosol therapy responsibilities? 9.
BF wheeze and dyspnea solve after several hours and aerosol treatments and he can expectorate his secretions. The provider discusses BF’s care of asthma with him; BF states that in the last few weeks he has had multiple asthma attacks. The provider discharges BF under a “burst” (prednisone 40mg/day X 5days), fluticasone/salmeterol (Advair HFA 230/21) oral steroid prescription, two inhalations daily morning-night (Proventil), albuterol (Proventil) metered-dose inhaler (MDI, spacer) and montelukast (Singulair). He instructed BF to phone the pulmonary clinic with a pulmonary expert for further follow-up.
10. What is the justification for BF’s oral steroid explosion?
11. How does Singulair differ from other treatments for asthma?
BF states that he took his Advair that morning, then again when he began to feel breathless. He says, “It didn’t help,” and he wants to know why he had to stay there. Is fluticasone/salmeterol (Advair) suitable for usage in acute asthma attacks? Explain.
12. What specific question do you need to address in BF Discharge Teaching, based on this information?
You are asking BF to show the use of its MDI. He shakes the box vigorously, hangs the spray on the edge of his mouth (pointing towards his cheek), and squeezes the box while he takes a quick, deep breath.
13. What are the common errors made by BF using the inhaler?
14. You review the correct use of a BF-based MDI and potential side effects such as hoarseness, dry mouth, oral cave white patches, cough and headaches. What measures can you teach him to minimize or reduce the impact of these effects? Choose everything that applies:
A. Reduce your fluid intake
b. Use an inhaler spacer
c. Only use the inhaler as specified
b. Rinse your mouth out promptly after inhalation
g. Clean the spacer in a “hot cycle with dry heated” dishwasher every day
RUBRIC
QUALITY OF RESPONSE |
NO RESPONSE |
POOR / UNSATISFACTORY |
SATISFACTORY |
GOOD |
EXCELLENT |
Content (worth a maximum of 50% of the total points) |
Zero points: Student failed to submit the final paper. |
20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. |
30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. |
40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. |
50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. |
Use of Sources (worth a maximum of 20% of the total points). |
Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. |
5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. |
10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. |
15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. |
20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. |
Grammar (worth maximum of 20% of total points) |
Zero points: Student failed to submit the final paper. |
5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors |
10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors |
15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. |
20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. |
Structure of the Paper (worth 10% of total points) |
Zero points: Student failed to submit the final paper. |
3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. |
5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper |
7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. |
10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. |
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