tahnz0

so would you take salbutamol to facilitate the inhalation of beclamathesone or to remove obstructing sputum?

so if one was having an attack, ventolin would be adminstered to relief bronchospasm, as it is a B2 adrenergic receptor agaonist. and then beclomathosane woould be administered as a maintence therapy. does anyone have any good resourses they can point me in the right direction? also if ones condition improves. would the pt still take ventolin first?

hi all, just wondering which inhaler is used first. beclamethasone (QVAR) inhaler or Salbutamol (ventolin) and why? tahnz0

thanx very much, why do you choose A.?

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

thankyou, i try not to rely on wikipedia, im just trying to find different avenues for an answer. thanks heaps!!

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

i believe that this is a hard question, and hard to understand unless you have expereienced blocked ears or whatever. i havnt had problems with my ears. but my nanna has blocked ears and she does the holding your nose thing. this question is crazy... thanx for your input

tahnz0 registered user join date: sep 2007 posts: 6 country: australia thanks: 12 thanked 0 times in 0 posts assistance - serous otitis media, valsalva manouvre permalink hi all, i have a few more qns, im finding all your input really great and allows me to broaden my thinking. thankyou so much!! case 1: ian adamson: impaired communictaion related to otitis media ian adamson, a four year old is admitted for investigation of gradual hearing loss in both ears. a provisional diagnosis of serous otitis media is made. qn1: how should ian be taught to perform the valsalva manoevre? a)compress both nostrils and ask him to blow out his cheeks with mouth closed b) place his hands over his ears and ask him to swollow hard c) hold a tissue over his nose and mouth and ask him to blow hard d) hold his breath and ask to swollow at the same time my thoughts.... valsalva discovered a muscle for opening the eustachian tube. he discribed the manouevre that is named after him as a method to expel pus from a tympanic cavity to the external auditory canal. i believe that otitis media is a form of dysfunction of the eustachian tube, which leads to negative pressure and formation of liquid in the middle ear. after a short time of negative pressure the number of mucous producing glands incresaes in the middle ear causing production of liquid as a consequence. in addition reducing hearing ability and maybe otitis media. i have read that the valsalva's manoeuvre is performed by pressing the nostrils together, closing the mouth and by means of the diaphragm pressure and increasing the pressure of the air in the mouth and nose cavity. the increased pressure so created is transplanted through the eustachian tube and equalised the negative pressure in themiddle ear. so this answer i feel supports answer a. although the paper also says that many children find it difficult to learn this technique. so then i ask myself is there other teaching strategies to perform this manoevre that children can perform and learn correctly? another piece i have read is the valsalvas manoevre is accomlished by gently blowing air in the middle ear while holding the nose, often called 'popping the ear' this didnt give me a technique tho, so i couldnt say which answer that fits with, i had a play around with the techniques above. and they all effected the ear. although the most effective for me was technique a. another reading, to equalise the pressure, pinch your nose shut and gently try to exhale through it. the air you are trying to exhale will be blocked by your pinched nose so it will end up in the dead air space in your ears, which equalises the pressure. swollowing also helps. here agian i believe this supports a. and also d. as the reading said swollowing helps. doesnt support b. or c. as they say to blow hard. so in conclusion by reading what i have read, i believe the most effective would be definatly a. and if a child is unable to appropriatly perform this, d. is easy and i would feel less scary for a child to forcefully try and pop there ears. so i have a toss up between a. and d. what does anyone else feel? sorry this post was so long

thnkyou very much for the links! i beleive you said the left lateral sims was the correct answer due to the physician being able to manupulate the sigmoioscope into the sigmoid colon. i am unable to find info on the other positions and feel that the only reason the others are not valis is due to cost of special ezuiptment/beds etc, and patient and physican comfort. pressure area care? does that come in anywhere, or is the patient not under anaesthetic long enough to aquire or have the risk of pressure area complications?

hi all, I am a nursing student and I have recieved a assignment question that i am having trouble with. its a multiple choice and a need to show knowlegde and rationales on the answers. miss bell is 25 years old. is admitted with provisional diagnosis of ulcerative colitis. qn1. the nurse should instruct pam to assume which of the following positions prior to sigmoidoscopy. a) left lateral sims b) right lateral c) knee-chest d) prone this is what im thinking but please someone add their bit of knowledge. a sigmoidoscopy is a direct visualisation of the sigmid colon and rectum with the use of a sigmoidoscope, looking for polys, CA or other abnormalities. i believe that the 3 common positions for sigmoidoscopy are 1. prone (jackknife) 2. left lateral (sims) 3. chest knee i have chosen left lateral (sims) to be the the best answer as its the most comfortable for the patient, it can be aquired on a normal hospital bed and does not require a special expensive table or bed like the Prone position does. it is essential that the buttocks are positioned over the edge of the bed as veiwing of the posterior wall of the upper rectum may require acute angulation of the instrument. i have read that the knee chest requires a special table as well. and some authors say that the knee chest position may be more comfprtable for the pt than prone but is awkward for the physician i have completed some placement at an operating theatre and i believe the left lateral position was used in every case that i saw regarding colonoscopy's. i do however feel that i dont have much of an argument about my answers. if anyone has any ideas.