[Answered]: Nitya Bhatt is a 47-year-old female accompanied…

Nitya Bhatt is a 47-year-old female accompanied by her spouse. She is being cared for in the emergency department due to an asthma exacerbation. Vital signs in triage are as follows: Temperature 36.8 ̊ C (98.3 ̊ F), Heart Rate 120/min, Respirations 28/min, Blood Pressure 100/64 mmHg, Oxygen Saturation 86% on room air. Past medical history: Childhood Encephalitis which resulted in total hearing loss. Asthma, depression, anxiety. COVID-19 (6 months prior). Home medications include: bupropion (Wellbutrin XL) 150 mg ER PO daily tiotropium (Spiriva) 2.5 mcg inhaler, take 2 puffs once daily budesonide/formoterol (Symbicort) 160mg/4.5 mcg metered dose inhaler. Take 1 puff daily as needed for asthma exacerbation, may repeat 1 puff if no relief after 5 minutes. Call provider if exceeding two weeks of use. The client uses American Sign Language for communication and can read lips. She uses an app on her phone to help with closed captioning of conversations and can communicate via reading and writing, if needed. The nurse completes a physical assessment which reveals the following: S1 and S2 heart sounds noted with tachycardia. Lung sounds diminished in lower left lobe. Bilateral expiratory wheezing noted to upper lung fields. The client is alert and oriented. The client writes “It’s just so hard to catch my breath,” on the white board and the client’s partner states, “She is really anxious.” The nurse also reviews arterial blood gas (ABG) results. Laboratory result (reference range) pH: 7.33 (7.35 – 7.45) PCo2: 48 mmHG (35-45 mmHg) HCO3: 30 mEq/L (21-28 mEq/L)