Nursing Care for a Patient with Acute Asthma and Incontinence

QUESTION

The change of shift report tells you that Ms. Priscilla Barnes, a 47-year-old, admitted with acute asthma, had a restless night. She is still dyspneic at 28 breaths/min and still demonstrating inspiratory and expiratory wheezes, although not as acute as they were at admission. She is maintaining an oxygen saturation of 90% to 92% on oxygen at 4 L/min via nasal cannula. She is receiving breathing treatments every six hours and but needed a prn treatment around 0300. She is receiving IV fluids of NS at 150 mL/hr and an aminophylline drip at 35 mL/hr. As you enter the room to do your shift assessment, Ms. Barnes tells you, “I don’t know what is going on with me. I have to go to the bathroom all the time and I just can’t make it there. I am so embarrassed—I just wet myself and the bed. I can’t catch my breath when I get up plus I can’t get there fast enough with all this stuff attached to me.”The change of shift report tells you that Ms. Priscilla Barnes, a 47-year-old, admitted with acute asthma, had a restless night. She is still dyspneic at 28 breaths/min and still demonstrating inspiratory and

ANSWER

Nursing Care for a Patient with Acute Asthma and Incontinence

Introduction

Providing care for patients with acute asthma can be challenging, especially when they experience additional complications like incontinence. This essay discusses the case of Ms. Priscilla Barnes, a 47-year-old patient admitted with acute asthma, and explores how to address her respiratory distress while managing her incontinence with empathy and professionalism.

Respiratory Assessment and Management

Ms. Barnes’ respiratory condition remains a primary concern. Her dyspnea, elevated respiratory rate (28 breaths/min), and persistent wheezing indicate ongoing airway obstruction. To manage her respiratory distress effectively, the following steps should be taken:

1. Assessment: Perform a comprehensive respiratory assessment, including auscultation of lung sounds, oxygen saturation monitoring, and evaluation of the effectiveness of previous treatments.

2. Breathing Treatments: Continue the prescribed breathing treatments as ordered, ensuring they are administered on schedule. Assess the patient’s response to these treatments and report any changes.

3. Oxygen Therapy: Maintain oxygen therapy at 4 L/min via nasal cannula to ensure adequate oxygenation while monitoring oxygen saturation levels closely. Adjust oxygen flow as necessary to maintain a saturation of at least 92%.

4. Medications: Ensure that Ms. Barnes receives her prescribed medications, including IV fluids of Normal Saline (NS) and the aminophylline drip. These medications help manage her asthma exacerbation.

5. Patient Education: Provide thorough education to Ms. Barnes regarding her asthma management, including the importance of medication compliance, recognizing worsening symptoms, and when to seek immediate assistance.

Addressing Incontinence and Patient Dignity

Incontinence can be distressing for both patients and healthcare providers. In Ms. Barnes’ case, it is essential to address her incontinence with empathy and professionalism:

1. Assessment: Assess the extent of the incontinence and its potential causes, such as medication side effects, fluid intake, or limited mobility due to respiratory distress.

2. Continence Care: Provide appropriate continence care, including cleaning and changing bed linens and clothing promptly. Use barrier creams to prevent skin irritation.

3. Mobility Assistance: Given Ms. Barnes’ difficulty in moving due to her respiratory condition, offer assistance with mobility to help her reach the bathroom safely when necessary.

4. Incontinence Products: Ensure that Ms. Barnes has access to appropriate incontinence products, such as absorbent pads or adult diapers, to maintain comfort and dignity.

5. Communication: Openly communicate with Ms. Barnes about her incontinence, reassuring her that healthcare professionals are there to support her and maintain her dignity during this challenging time.

6. Privacy and Respect: Always provide care with the utmost respect for her privacy and dignity, ensuring that curtains are drawn and doors are closed when attending to her needs.

Conclusion

Caring for a patient like Ms. Priscilla Barnes, who is experiencing acute asthma exacerbation alongside incontinence, requires a compassionate and multidimensional approach. Prioritizing her respiratory management while addressing her incontinence with empathy and professionalism is essential. By maintaining her comfort, dignity, and effective asthma treatment, healthcare providers can contribute to her overall well-being and recovery. Effective communication and patient-centered care play pivotal roles in ensuring that Ms. Barnes feels supported and respected throughout her healthcare journey.