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Condition Assessment and Diagnosis
It should be noted from the onset that patients who are asthmatic ought to manage their asthma in a proper manner during pregnancy. This is more so the case given the need to minimize complications during the term of the pregnancy. It is important to note that some of the problems that could result as a consequence of poorly controlled asthma during pregnancy include, but they are not limited to; hypertension, premature birth, as well as restricted fetal growth (Vincent, Abraham, Kochanek, and Fink, 2011). It therefore follows that in the scenario recounted, the key concern would be the pregnant female patient’s control of her asthma at this point in time.
There would be need to find out if the patient has been taking her asthma medications as recommended since she became pregnant. A thorough physical examination as well as patient history would also be of great relevance on this front. In a scenario such as this one, Shedd and Hays (2016) recommend objective measures of lung function. According to the authors, “spirometry, peak expiratory flow rate (PEFR), and standardized questionnaires are valuable measures of how well a patient’s asthma is controlled…” (Shedd and Hays, 2016, p. 103).
The differential diagnosis for the patient’s edema as well as shortness of breath would be cardiac asthma. It is important to note that when it comes to cardiac asthma, pulmonary oedema happens to be the consequence of the impaired pumping efficiency of the heart’s left side. The most common symptoms of cardiac asthma include, but they are not limited to, breathlessness, increased heart rate, increased blood pressure, shallow breathing, cough, etc. According to Shedd and Hays (2016), “because pregnancy can, by itself, induce dyspnea, it is possible that this state may make previously occult pulmonary, cardiac, or hematologic disorders noticeable” (105).
References
Shedd, G.C. & Hays, C.N. (2016). The Pregnant Patient with Asthma: Assessment and Management. The Journal for Nurse Practitioners, 12(1), 102-107.
Vincent, J., Abraham, E., Kochanek, P. & Fink, M.P. (2011). Textbook of Critical Care. Philadelphia, PA: Elsevier Health Sciences.
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