Status asthmaticus

  1. hi guys, another question i need your insight with.

    jane betterman, 19 years old, is a known asthmatic who has been maintained on prednisone and salbutamol (ventolin). she is admitted to hospital in status asthmaticus, and is prescribed an infusion of 500mg aminophylline in 500ml normal saline (0.9%)saline.

    qn 1. the term status asthmaticus refers to an attack which
    a) continues despite conventional therapy
    b) lasts longer than any other previous attack
    c) is of idiopathic origin
    d) is precipitated by a respiratory infection

    my thoughts....

    status athmaticus is a medical emergency in which asthma symptoms are refractory to initial bronchodilator therapy.

    one of the reading i have read say status asthmaticus is the condition of a pateint in pregressive respiratory failure due to asthma, in whom conventional forms of therapy have failed.. this bit of info supports a. and d. any patient not responding to initial doses of nebulising bronchodilating agents should be considered to have status athmaticus i believe this bit supports a. as well

    wikipedia state
    status asthmaticus is an acute exacerbation of asthma that does not respond to standard treatments of bronchodilators and corticosteroids. symptoms include chest tightness, rapidly progressive dyspnea (shortness of breath), dry cough and wheezing.
    the lung failure means that oxygen can no longer be provided, carbon dioxide can no longer be eliminated, which leads to acidosis. thus again supporting answer a.

    another reading stated
    definition: status asthmaticus is a life threatening form of asthma defined as “a condition in which a progressively worsening attack is unresponsive to the usual appropriate therapy with adrenergic drugs and that leads to pulmonary insufficiency.”

    with the readings i have read most support a. i havnt actualy seen anyone or cared for anyone in status asthmaticus. so any help either with ones own experience or knowldege and any helpful website would be greatly appreciated.

    thanx tahnz0
    Last edit by tahnz0 on Sep 24, '07
    •  
  2. 15 Comments

  3. by   deeDawntee
    Yes, A.
  4. by   jen123321
    Wikipedia is not a reliable source, just so you know.
  5. by   tahnz0
    Quote from jen123321
    Wikipedia is not a reliable source, just so you know.
    thankyou, i try not to rely on wikipedia, im just trying to find different avenues for an answer.

    thanks heaps!!
  6. by   Kinky Slinky RN
    I say definitely A as well
  7. by   tahnz0
    Quote from deeDawntee
    Yes, A.

    thanx very much, why do you choose A.?
  8. by   deeDawntee
    Quote from tahnz0
    thanx very much, why do you choose A.?
    Ooops, sorry...

    I just got my CCRN and that was the definition. None of the conventional treatments work for these patients. They often require intubation. It is actually very serious and people can die.
    You want them to be alkalotic, if they become acidotic, they had better be intubated stat or they will not be around for long.
  9. by   rodeosweetheart
    Hi, I'm a pre-nursing student awaiting application results. I'm a severe asthmatic and have had several status asthmaticus attacks , and my understanding is yes, it would be A. Treatment would generally also include drugs other than aminophylline--specifically, often epinephrine, iv steroids, oxygen with breathing treatments of albuterol. I have not been given aminophylline for this for many years now. Instead, they go to epinephrine, oxygen, albuterol, steroids, oxygen, antibiotics, sometimes magnesium (a European thing). When none of these did the trick, they did intubate me one time. It could not be D as these attacks can also be allergic in origin--my pulmonologist said the one that almost got me was actually anaphyllactic shock on top of the asthma(?)
    But basically it's a progressively bad situation, very quickly, that will not get better without medical intervention. Those who experience these attacks are put in a category of most severe asthma, because having one such attack is a risk factor for having another. It is my understanding that this term is used only for this kind of attack, and those who have them are considered brittle, and can go very quickly from stable to not stable.
    My own pet peeve is that yes, if you have this kind of attack they want you on steroids to maintain, but when I have had them, I've gone from quite healthy to in serious trouble in matter of a few hours, and they've been usually brought on by a respiratory infection, and I've even been taking steroids, so I don't see that the maintainance prevents these. There seems to be something else going on that no one has yet figured out. HTH
  10. by   bigsyis
    A is the correct answer.
  11. by   leslie :-D
    i agree w/others.
    actually, A was the only answer for me.

    and thanks for the heads-up about wikipedia.
    i had no idea, and i reference them often.
    why aren't they reputable?

    leslie
  12. by   woody62
    Quote from rodeosweetheart
    Hi, I'm a pre-nursing student awaiting application results. I'm a severe asthmatic and have had several status asthmaticus attacks , and my understanding is yes, it would be A. Treatment would generally also include drugs other than aminophylline--specifically, often epinephrine, iv steroids, oxygen with breathing treatments of albuterol. I have not been given aminophylline for this for many years now. Instead, they go to epinephrine, oxygen, albuterol, steroids, oxygen, antibiotics, sometimes magnesium (a European thing). When none of these did the trick, they did intubate me one time. It could not be D as these attacks can also be allergic in origin--my pulmonologist said the one that almost got me was actually anaphyllactic shock on top of the asthma(?)
    But basically it's a progressively bad situation, very quickly, that will not get better without medical intervention. Those who experience these attacks are put in a category of most severe asthma, because having one such attack is a risk factor for having another. It is my understanding that this term is used only for this kind of attack, and those who have them are considered brittle, and can go very quickly from stable to not stable.
    My own pet peeve is that yes, if you have this kind of attack they want you on steroids to maintain, but when I have had them, I've gone from quite healthy to in serious trouble in matter of a few hours, and they've been usually brought on by a respiratory infection, and I've even been taking steroids, so I don't see that the maintainance prevents these. There seems to be something else going on that no one has yet figured out. HTH
    I've suffered from asthma since 1973. Onset was at the age of 28. Mine is bought on by exposure to cat dander. I have suffered from status several times, to various degrees ranging from necessary intubation to repeated neubulizer treatments. I have not had an aminphyllin treatment in years. When I appear in the ER, I am treated with up to four albuterol nebs treatments, magnesium infusing, steroid infusion. If these do not bring my attack under control, I am considered in status by the ER physician, my pulmonalogist. Depending on my ABG's, I am put on either O2 or being intubated. I continue to received steroids IV along with the nebs. I rarely have accompanying infections but when I do, I am treated with IV antibiotics. And I am always discharged home to a decreasing medrol pack. My doctors define my status as when I fail to respond to conventional treatment, necessitating in continued nebs, steroids and O2. I am also an insulin dependent Type 2 diabetic and the steroids play havoc with my blood sugars. I am on a sliding scale of regular insulin until I am no longer on steroids. It puts me between a rock and a hard place but a necessary one.
    Woody
  13. by   shellsincanada
    Quote from earle58
    i agree w/others.
    actually, A was the only answer for me.

    and thanks for the heads-up about wikipedia.
    i had no idea, and i reference them often.
    why aren't they reputable?

    leslie

    A as well.

    wikipedia is made up by the users and can be edited by anyone. I love it for a quick look at something- but there can be inaccuracies because of the fact anyone can edit it. One of those things that you have to "consider the source". Could be accurate one day and not the other , accurate about one thing and not the other.
  14. by   Spritenurse1210
    I think it's A.

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