3.3.4 Medical History #4 15

Case History Melissa has shown an increase of symptoms over the past month. After one late night at a school carnival, Melissa was admitted to the hospital with a severe asthma attack. She did not have an inhaler with her at the event. Luckily her friends were able to find her parents in time to get her medical attention. Assessment of her prescription record shows that she has not been compliant with her daily medication. She should have refilled her prescription weeks ago. Melissa notes that it is embarrassing having to use the inhaler and that her daily medication often makes her feel lightheaded. Melissa’s mother notes that she now vacuums the entire house every 2-3 days, but Melissa spends a great deal of time out of the home. It is hard to control her exposure to dust, a trigger that definitely puts stress on her airways. Melissa has continued to keep a peak flow diary. On many days she records values in the Yellow Zone. At this visit her FEV1 was 77%. Melissa has agreed to meet with the respiratory therapist on staff to work on an asthma action plan and discuss how to deal with her asthma triggers. These issues had been discussed when medications were initially prescribed, but detailed work now needs to be done to stress the importance of ca