D.R. is a 27-year-old man, who presents to the nurse practitioner at the Family Care Clinic complaining of increasing SOB, wheezing, fatigue, cough, stuffy nose, watery eyes, and postnasal drainage—all of which began four days ago. Three days ago, he began monitoring his peak flow rates several times a day. His peak flow rates have ranged from 65-70% of his regular baseline with nighttime symptoms for 3 nights on the last week and often have been at the lower limit of that range in the morning. Three days ago, he also began to self-treat with frequent albuterol nebulizer therapy. He reports that usually his albuterol inhaler provides him with relief from his asthma symptoms, but this is no longer enough treatment for this asthmatic episode

D.R. is a 27-year-old man, who presents to the nurse practitioner at the Family Care Clinic complaining of increasing SOB, wheezing, fatigue, cough, stuffy nose, watery eyes, and postnasal drainage—all of which began four days ago. Three days ago, he began monitoring his peak flow rates several times a day. His peak flow rates have ranged from 65-70% of his regular baseline with nighttime symptoms for 3 nights on the last week and often have been at the lower limit of that range in the morning. Three days ago, he also began to self-treat with frequent albuterol nebulizer therapy. He reports that usually his albuterol inhaler provides him with relief from his asthma symptoms, but this is no longer enough treatment for this asthmatic episode

D.R. is a 27-year-old man, who presents to the nurse practitioner at the Family Care Clinic complaining of increasing SOB, wheezing, fatigue, cough, stuffy nose, watery eyes, and postnasal drainage—all of which began four days ago. Three days ago, he began monitoring his peak flow rates several times a day. His peak flow rates have ranged from 65-70% of his regular baseline with nighttime symptoms for 3 nights on the last week and often have been at the lower limit of that range in the morning. Three days ago, he also began to self-treat with frequent albuterol nebulizer therapy. He reports that usually his albuterol inhaler provides him with relief from his asthma symptoms, but this is no longer enough treatment for this asthmatic episode

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icon Discussion 3

Pulmonary Function:

D.R. is a 27-year-old man, who presents to the nurse practitioner at the Family Care Clinic complaining of increasing SOB, wheezing, fatigue, cough, stuffy nose, watery eyes, and postnasal drainage—all of which began four days ago. Three days ago, he began monitoring his peak flow rates several times a day. His peak flow rates have ranged from 65-70% of his regular baseline with nighttime symptoms for 3 nights on the last week and often have been at the lower limit of that range in the morning. Three days ago, he also began to self-treat with frequent albuterol nebulizer therapy. He reports that usually his albuterol inhaler provides him with relief from his asthma symptoms, but this is no longer enough treatment for this asthmatic episode.

Case Study Questions

According to the case study information, how would you classify the severity of D.R. asthma attack?

Name the most common triggers for asthma in any given patients and specify in your answer which ones you consider applied to D.R. on the case study.

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Based on your knowledge and your research, please explain the factors that might be the etiology of D.R. being an asthmatic patient.

Fluid, Electrolyte and Acid-Base Homeostasis:

Ms. Brown is a 70-year-old woman with type 2 diabetes mellitus who has been too ill to get out of bed for 2 days. She has had a severe cough and has been unable to eat or drink during this time. On admission, her laboratory values show the following:

Serum glucose 412 mg/dL

Serum sodium (Na+) 156 mEq/L

Serum potassium (K+) 5.6 mEq/L

Serum chloride (Cl–) 115 mEq/L

Arterial blood gases (ABGs): pH 7.30; PaCO2 32 mmHg; PaO2 70 mmHg; HCO3– 20 mEq/L

Case Study Questions

Based on Ms. Brown admission’s laboratory values, could you determine what type of water and electrolyte imbalance does she has?

Describe the signs and symptoms to the different types of water imbalance and described clinical manifestation she might exhibit with the potassium level she has.

In the specific case presented which would be the most appropriate treatment for Ms. Brown and why?

What the ABGs from Ms. Brown indicate regarding her acid-base imbalance?

Based on your readings and your research define and describe Anion Gaps and its clinical significance.

Submission Instructions:

You must complete both case studies

Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.

You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)

All replies must be constructive and use literature. MUST be done on a SEPARATE day from the initial post.

Please post your initial post by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.

You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.

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Grading Rubric

Your assignment will be graded according to the grading rubric.

Discussion Rubric
Criteria Ratings Points

Identification of Main Issues, Problems, and Concepts
Distinguished – 5 points

Identifies and demonstrates a sophisticated understanding of the issues, problems, and concepts.

Excellent – 4 points

Identifies and demonstrates an accomplished understanding of most issues, problems, and concepts.

Fair – 1-3 points

Identifies and demonstrates an acceptable understanding of most issues, problems, and concepts.

Poor – 0 points

Identifies and demonstrates an unacceptable understanding of most issues, problems, and concepts. Or nothing was posted.

5 points

Use of Citations, Writing Mechanics, and APA Formatting Guidelines

Distinguished – 3 points

Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.
Excellent – 2 points

Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors.

Fair – 1 point

Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail.

Poor – 0 points

Ineffectively uses the literature and other resources to inform their work. Unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention. Or nothing was posted.

3 points
Response to Posts of Peers

Distinguished – 2 points

Student constructively responded to two other posts and either extended, expanded, or provided a rebuttal to each.

Fair – 1 point

Student constructively responded to one other post and either extended, expanded, or provided a rebuttal.

Poor – 0 points

Student provided no response to a peer’s post.