30) Shelly is a 30-year-old female patient who presents to the clinic with an asthma attack. Clinical records show that she has been admitted to the hospital on several occasions and once to ICU within the past 12 months. On assessment, she was finding it difficult to complete full sentences and had a 48-hour history of an upper respiratory illness with increasing shortness of breath and wheezing for the past six hours. Her prescribed asthma medication was a twice-daily inhaled corticosteroid in combination with a long-acting beta-2 agonist and inhaled salbutamol. She normally used salbutamol once or twice a day but over the past two days her use had increased to eight to 10 times per day and she could not sleep because of her breathlessness and wheezing. Her vital signs are temperature 37° C, blood pressure 190/88 mm Hg, pulse 122 beats/minute, and respiratory rate 32 breaths/minute, oxygen saturation (O2 sat) is 88%.
1. Discuss the policy and procedure for administering nebulisation.
2. Discuss the maintenance and cleaning of nebulisers as per the policies and procedures.
Shelly states that she sometimes suffers from anxiety and chest pain after an asthma attack. Shelly states that she would prefer not to take medications for her anxiety and chest pain and is refusing her analgesia. Discuss your actions and consider the complementary therapies that you may suggest to Shelly to consider.