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QUESTION

Create a 4 pages page paper that discusses reflective exercise. J., 2007).For ethical reasons, the identity of the patient that I am going to discuss now will remain confidential. I will call him Joe

Create a 4 pages page paper that discusses reflective exercise. J., 2007).

For ethical reasons, the identity of the patient that I am going to discuss now will remain confidential. I will call him Joe throughout this reflective exercise. He is a 25-year-old young man whom I have been treating. He is a university student, extremely pleasant, and severely irritated and impatient when in distress. He gets care in my practice for his bronchial asthma. He started having his attacks in adolescence, and suffering has imparted a stoic indifference to instructions to avoid an attack or on medications. As a practitioner, I am offering him treatments in my general practice surgery as an independent nurse prescriber for few years. In the beginning, his parents used to accompany him, specially when he used to have a severe attack. Medications in the form of steroids and bronchodilators had been routine. Despite this, he continues have attacks and flare-ups almost at seasonal intervals. Now, he is on inhaler therapy, since inhalers are treatments of choice in cases of bronchial asthma (Horiguchi, T. et al., 2006). Not only for NHS guidelines, current teaching suggests that aerosol inhalers taken regularly would prevent an attack of bronchial asthma and may be successful in achieving and maintaining a steady state for such patients. Initially, he was particular in using his inhaler schedule, but currently, it has been observed that he is having frequent attacks. On enquiry, it was revealed that he has not been using his inhalers. When I confronted him, he divulged that he thinks his inhalers are no longer acting. furthermore, he thinks inhaler is something habit forming. He would rather go for some oral medications or injectables for his problem. Honestly, I was first extremely irritated and desperately tried to stress on the fact that he will have to accept my prescription (Jantikar, A., et al., 2007).

Description:

When he presented to the clinic, there was audible wheezes. he was coughing incessantly. His accessory muscles of breathing were very prominent. There was nasal flare with a rapid breathing rate. Evidently, he was in distress. When I examined him, he was having no evidence of cyanosis in the nail beds, but his discomfort was evident from auscultation of his chest. The bronchospasm was evident from the wheeze and rhonchi. He was in distress. his blood pressure and heart rate were both little elevated, and psychologically, perhaps, this is called acute distress. He attended the clinic 2 weeks ago with almost an episode similar in intensity, and he was advised inhaler therapy with salbutamol and betamethsone. As far as my experience goes, 2 puffs twice daily of salbutamol and 2 puffs twice daily of betamethsone would be sufficient to provide and relief and continuing these in the same schedule would help maintain a symptom-free state in Joe. I was upset to see him back in the surgery because it was absolutely contrary to my expectations about the clinical outcome in case of Joe (Tatsis, G., Kotsifas, K., Filaditaki, V., Makrantoni, G., and Boulia, S., 2007). It was more frustrating to know that he has not use his inhalers due to misconception and unawareness, and as expected has entered into another episode.

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