CASE STUDY – ASTHMA
(adapted from Winningham, 2013Critical Thinking Cases in Nursing)
Scenario
B.T., a 22-year-old man who lives in a small mountain town in Colorado, and is highly allergic to dust and
pollen. B.T.'s wife drove him to the clinic when his wheezing was unresponsive to fluticasone/salmeterol
(Advair) and ipratropium bromide (Atrovent) inhalers, he was unable to lie down, and he began to use
accessory muscles to breathe. B.T. is started on 4 L oxygen by nasal cannula and an IV of D5W at 15
mL/hr. He appears anxious and says that he is short of breath.
Vital Signs
Blood pressure 152/84 mm Hg
Pulse rate 124 beats/min
Respiratory rate 42 breaths/min
Temperature 100.4 ° F (38.4 ° C)
Medication Orders
Albuterol 2.5 mg plus ipratropium 250 mcg nebulizer treatment STAT
Albuterol (Ventolin) inhaler 2 puffs q4h
Metaproterenol sulfate (Alupent) 0.4% nebulizer treatment q3h
Fluticasone (Flovent) 250 mcg by MDI twice daily
_____________________________________________________________________________________________________________________
1. Are B.T.'s vital signs (VS) acceptable? State your rationale.
B.T.’s vital signs are not acceptable for a patient his age. His systolic blood pressure is elevated. B.T.’s heart
rate is increased as well. Respiratory rate, and temperature are both above normal expectancies.
This study source was downloaded by 100000901307859 from CourseHero.com on 10-15-2025 22:38:09 GMT -05:00
https://www.coursehero.com/file/27066817/Asthma-Case-Studydocx/
(adapted from Winningham, 2013Critical Thinking Cases in Nursing)
Scenario
B.T., a 22-year-old man who lives in a small mountain town in Colorado, and is highly allergic to dust and
pollen. B.T.'s wife drove him to the clinic when his wheezing was unresponsive to fluticasone/salmeterol
(Advair) and ipratropium bromide (Atrovent) inhalers, he was unable to lie down, and he began to use
accessory muscles to breathe. B.T. is started on 4 L oxygen by nasal cannula and an IV of D5W at 15
mL/hr. He appears anxious and says that he is short of breath.
Vital Signs
Blood pressure 152/84 mm Hg
Pulse rate 124 beats/min
Respiratory rate 42 breaths/min
Temperature 100.4 ° F (38.4 ° C)
Medication Orders
Albuterol 2.5 mg plus ipratropium 250 mcg nebulizer treatment STAT
Albuterol (Ventolin) inhaler 2 puffs q4h
Metaproterenol sulfate (Alupent) 0.4% nebulizer treatment q3h
Fluticasone (Flovent) 250 mcg by MDI twice daily
_____________________________________________________________________________________________________________________
1. Are B.T.'s vital signs (VS) acceptable? State your rationale.
B.T.’s vital signs are not acceptable for a patient his age. His systolic blood pressure is elevated. B.T.’s heart
rate is increased as well. Respiratory rate, and temperature are both above normal expectancies.
This study source was downloaded by 100000901307859 from CourseHero.com on 10-15-2025 22:38:09 GMT -05:00
https://www.coursehero.com/file/27066817/Asthma-Case-Studydocx/
