Final answer:
Immediate orders for an acute exacerbation of bronchial asthma with respiratory distress would include providing supplemental oxygen, initiating bronchodilators, administering systemic corticosteroids, and considering anticholinergic medications. Further orders would depend on the patient's response to initial treatment and the severity of the exacerbation. Final orders would involve adjustments in medication doses and planning for follow-up care.
Step-by-step explanation:
When a patient presents with an acute exacerbation of bronchial asthma along with respiratory distress, immediate orders are necessary to provide prompt treatment and alleviate symptoms. The initial examination should involve assessing the patient's vital signs, such as pulse rate, respiratory rate, and oxygen saturation. Additionally, a physical examination should be conducted to evaluate lung sounds and any signs of respiratory distress.
The initial orders for a patient with an acute exacerbation of bronchial asthma and respiratory distress typically include providing supplemental oxygen to improve oxygenation, initiating bronchodilators (such as short-acting beta-agonists) to relax the airway muscles and alleviate bronchospasm, administering systemic corticosteroids to reduce airway inflammation, and considering the use of anticholinergic medications to further relax the airways. These medications can be administered through an inhaler or a nebulizer depending on the patient's ability to use the device.
After obtaining the results of the initial examination and tests, further orders may be required based on the severity of the exacerbation and the patient's response to initial treatment. This may include additional bronchodilators, adjusting the dose of systemic corticosteroids, or initiating adjunct therapies such as magnesium sulfate or heliox. If the patient's symptoms are severe and do not improve with initial treatment, hospital admission may be necessary for closer monitoring and management. The admission orders may involve continuous oxygen therapy, aggressive bronchodilator therapies, intravenous corticosteroids, and respiratory support if needed. Finally, the final orders would depend on the patient's response to treatment and the overall management plan, which can include adjustments in medication doses, additional investigations, and planning for follow-up care.