Assignment task:
Sara, a 36-year-old woman, is admitted to your medical floor directly from her primary care physician's office with the diagnosis of asthma exacerbation. Her vital signs are 134/88, 94, 28, 99.4, and 88% oxygen saturation on room air. You place her on 2 L of oxygen via nasal cannula; her oxygen saturation rises to 95%, and her respiratory rate decreases to 22 respirations/minute. You auscultate Sara's lungs, and she has expiratory wheezes with diminished breath sounds in the lower lobes bilaterally. During the admission process, Sara tells you that along with chronic asthma and hypertension, for which she takes lisinopril (Prinivil®) 10 mg daily. She uses a fluticasone propionate (Flovent®) aerosol inhaler twice a day to keep her asthma under control. In addition, she was just diagnosed with type 2 diabetes and takes 500 mg metformin (Glucophage®) by mouth twice daily. Sara weighs 220 pounds and is 5 feet 8 inches tall. Her BMI is 33.4 (a BMI higher than 30 qualifies Sara as obese). Sara takes oral contraceptives every morning. The physician who will be caring for Sara calls you from the ICU and says that he will see Sara later in the shift. You report that Sara's respiratory