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Alex 19 year old male was admitted to ED at 2000hrs with severe breathlessness. History of Asthma diagnosed at 3years.

Sign and symptoms
Severe dyspnoea inability to speak sentence in one breath. RR 33 breaths/min, SPO290%on room air, BP 150/85 mmHg, HR 130 beats/min. On Auscultation of lungs identified diminished breath sound and widespread wheeze.

Chest X-ray clear and hyper inflated lung field.

ABG
pH 7.35, PaO2 60mmHg, PaCO2 50mmHg, HCO3 25 Eg/L, Lactate 1 , Sa02 90%

A diagnose of Acute severe Asthma was made.

Q1. Explain the pathogeneses causing the clinical manifestation with which Alex presented with 600 Words..

Q2. Discuss two high priority nursing strategies to manage Alex and provide rationale for these strategies .250 words

Q3. Three drugs that were given, continuous nebulised Salbutamol, Ipratropium bromide 4/24 and IV Hydrocortisone100mg 6/24.(300 words)

A) Discuss the mechanism of action of these drugs and relate to the underlying pathogenesis of Acute Severe Asthma.

B) Describe the nursing implication (monitoring for and responding to adverse effect, and evaluating therapeutic effect) when administering these drugs to patient with Acute Severe Asthma.

APA Style reference, 6 academic references can include journal article, text book, and government website all within 5years from 2013 onwards.

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