Mary is a 51-years old female who has been a bookkeeper for the large part of her lifetime. In her childhood days, Mary had a weak chest in her childhood, but these problems have significantly reduced in her adulthood save for occasional colds during the cold season. Mary admits that she thinks that she would experience some wheeziness in case she participated in exercise, but she has had a sedentary lifestyle and thus there was no cause for worry with her asthma (British Thoracic Society, 2015). Mary’s symptoms over the last five years have increased gradually even amidst the regular use of inhaler steroids.
With Mary’s mother having been had a broken femur Mary has assumed the duties of dog walking every morning. The morning walk has been dreary for Mary and has severally triggered a wheeze which has caused her uncomfortable situations for the better part of her mornings. Mary has been using her reliever more frequently since she assumed this new role and this is the reason she has decided to visit her primary care provider (British Thoracic Society, 2015). Asthma is a respiratory condition that is usually triggered by events and allergies such as cold air, dust, pollen as well as inadequate ventilation within a setting. Asthma occurrence is unpredictable and the patient may experience cases of shortness of breath which if not manage timely could lead to other severe complications (Jarvis, 2015).
In this case, the primary care provider failed to inform their patient Mary of the unavoidable triggers which in Mary’s case would include exposure to chilly conditions or the use of cold drinks. Having been under inhaler steroids, it was important for the primary care provider to indicate that the inhaler is a last resort mechanism for the patient in the event that they experience cases of shortness of breath. Spirometry tests need to be initiated to help determine the narrowing of the bronchial tubes (Jarvis, 2015). Similarly, peak flow tests can help determine how hard the patient can breathe and thus provide an informed view of the lung function as well as the stage of asthma. In the event that Mary’s case has reached severity levels of risk, the patient can be subjected to a new inhaler dose of long-acting beta agonist such as salmeterol, formoterol as well as the integration of Leukotriene modifiers which would help relieve symptoms for up to 24 hours when the patient is in an environment that characterizes high risk (Du & Yuan, 2010).
References
British Thoracic Society. (2015). British Guideline on the Management of Asthma. Retrieved from http://www.sign.ac.uk/pdf/sign101-asthma-case-study-mary.pdf
Du, S., & Yuan, C. (2010). Evaluation of patient self‐management outcomes in health care: a systematic review. International nursing review, 57(2), 159-167.
Jarvis, C. (2015). Physical examination & health assessment (7th ed.). St. Louis, MO: Saunders Elsevier.
