Concordia College

College of Nursing

Case
Study
On
Bronchial
Asthma

Prepared By:
De Castro, Richelle Sandriel C.
BSN III-D

Submitted To:
Ms. Susie May Jardio RN, RM, MSN
I. INTRODUCTION
 Asthma is a chronic inflammatory respiratory disorder that causes recurrent
episodes of wheezing, breathlessness, chest tightness and cough, especially at
night or in the early morning. These asthma episodes are associated with airflow
limitation or obstruction that is reversible either spontaneously or with treatment.
Asthma usually begins in childhood or adolescence, but it also may first appear
during adult years. While the symptoms may be similar, certain important aspects
of asthma are different in children and adults.

Bronchial asthma is the more correct name for the common form of asthma. The
term 'bronchial' is used to differentiate it from 'cardiac' asthma, which is a separate
condition that is caused by heart failure. Although the two types of asthma have
similar symptoms, including wheezing (a whistling sound in the chest) and
shortness of breath, they have quite different causes.

Bronchial asthma is usually intrinsic (no cause can be demonstrated), but is

occasionally caused by a specific allergy (such as allergy to mold, dander, dust).
This case study is a thorough learning about Bronchial Asthma, which contains a
study about the normal physiology of the respiratory system, pathological
physiology of the disease, a thorough assessment of the patient with said illness,
applied nursing care plans to patients having this kind or disease, and discharge
planning to a patient to limit the recurrence of the attack or if not proper
management and care to be given during the time of asthma attack.

II. OBJECTIVES OF THE STUDY

At the end of the case study, the student will be able to:
• Know what Bronchial Asthma is all about.
• Apply the knowledge that they have learned in the floor.

III. PATIENT’S PROFILE

Name: T.M
Address: Western Bicutan, Taguig
Age: 25 years old
Date of Birth: November 16, 1984
Sex: Female
Nationality: Filipino
Religion: Roman Catholic
Date & Time of Admission: May 17, 2010 (03:25 pm)
Mode of Arrival: Wheelchair
Chief Complaint: Pruritic Rashes
Source of Information: Patient, Chart

IV. HISTORY OF PRESENT ILLNESS

The patient was diagnosed with bronchial asthma since 2008 given Salbutamol
nebulization as necessary.
2 days prior to admission, the patient experienced non productive cough, watery
nasal discharge, and (-) fever, and decreases in appetite.
1 day prior to admission, the patient experienced difficulty of breathing, excessively
vomit once.
 Few hours prior to admission, they went to San Juan de Dios Hospital for
consultation, the patient experienced persistence of difficulty of breathing.
 V. LABORATORY WORKS

NAME OF TEST NORMALVALUE RESULTS SIGNIFICANCE

Complete Blood Count RBC: 4-6 x 10/L 4.28 Increased segmenters (mature
Hct: 0.37- 0.47 0.36 neutrophils) reflect a bacterial
Purpose: CBC is ordered to aid in the Hgb: 110- 160 gm/L 111 infection since this are the
detection of anemias; hydration WBC: 5-10 x 10 /L 11.3 body’s first line of defense
status; and as part of routine Lymphocytes:0.25-0.35 0.25 against acute bacterial
hospital admission test. The Segmenters: 0.50-0.65 0.74 invasion.
differential WBC is necessary for Eosinophil: 0.01-0.06 0.01 Lymphocytes are decreased
determining the type of infection. during early acute bacterial
infection and only increase
late in bacterial infections but
continue to function during
the chronic phase.

VI. DRUG STUDY

Generic/Brand Action Indication/ Adverse Reaction Nursing
Name Classification Responsibility
1.Salbutamol . Assess cardio-respiratory
function: BP, heart rate and
rhythm and breath sounds

Determine history of
previous medication and
ability to self medicate to
prevent additive.

Monitor for evidence of

allergic reaction and
paradoxical bronchospasm.
DISCHARGE SUMMARY

Medication
Patient will be compliant to continued medication regimen

Exercise
Patient will verbalize need importance of exercise and demonstrate proper initiation
of appropriate exercise.

Treatment
Patient will know appropriate treatment regimen and verbalize compliance.

Hygiene
Outpatient
Diet
Spiritual

VII. PATHOPHYSIOLOGY

Causal Factors
Predisposing Factor -Exposure to indoor Contributing Factors
-Atopy and outdoor -Respriratory infections
-Female gender allergens -Air pollution
-Occupational -Others: diet, small size
sensitizers at birth

Inflammation

Hyperresponsiveness
of airways Airflow limitation

-Risk Factors for

Exacerbations
-Allergens Symptoms
-Respiratory infections Wheezing
-Exercise and hyperventilation Cough
-Weather changes Dyspnea
-Exposure to sulfur dioxide Chest tightness
-Exposure to food, additives,
medications