Consider the case study below:

Johnny is a 14-year old male who was presented at the emergencydepartment with a status asthmaticus. Hisfather reported that he had just been picked for the school soccerteam and was playing his first game when he started to wheeze,however he did not want to come off and use his prescribedinhalers. His father also reported that this has been the case moreand more as Johnny moved into his teenage years and often getsembarrassed about using his inhaler in front of his friends. Hisfather has also mentioned that he feels that Johnny is not managinghis asthma well and is struggling in the transition on to teenyears by wanting to manage his asthma independently however, helacks the proper skills to execute this well. They have not seen anasthma specialist for over seven years as until now Johnny's asthmahad been very stable and have not needed any plans orinterventions. On examination, Johnny had an audible wheeze and isunable to speak in full sentences. His respiratory rate is 35 bpm,pulse oximetry reveals an SaO₂ of 88% and a pulserate of 132. He appears slightly cyanotic and was visibly anxiousand distressed. When asked what medication he was taking, hisfather said that Johnny had just been taking his "normal puffer"(i.e. salbutamol metered dose inhaler) however, Johnny said that hehad also been taking ibuprofen for a sprained ankle he sustainedduring training for the last week or so.

Answer the following questions:

i) Using the clinical reasoning cycle as aframework, you are required to plan, assess and evaluate your carefor this case study. Identify and discuss TWO currentproblems which are DIRECTLY impacting the patient's health and howthe assessment data led you to identify these TWOproblems. Discuss the underlyingpathophysiology that explains the link between each of the chosenproblem and the case's relevant assessment data given (refer tothem when answering the question). Model your TWO problems assuch, for example: Acute chestpain related to insufficient coronaryartery perfusion as evidenced by selfreport of radiating and central chest pain. Use thestatement "related to ... as evidenced by ..." when identifyingyour TWO problems for the case study.

ii) For EACH problem, identifyTWO interventions aimed at resolving that particularproblem. So for each problemidentified, identify TWO interventions (one can becollaborative (focused on what the nurse's role in thecollaborative intervention is) and the other must be independent)to resolve that problem. To simplify this question, for each of theproblems identified from (i) (they must be TWO problems), identifyTWO interventions for EACH of the identified problems, which can becollaborative (discuss on what will be nurse's role in thiscollaborative intervention) and the other MUST be independent.

NOTE: Prescribed therapies cannot be both of the chosecollaborative interventions for a problem. If a prescribed therapyis ONE of your collaborative interventions, you must then considerand discuss relevant nursing responsibilities associated with thattherapy (i.e. action, dose, side effects, prevention and managementof administration requirements and evaluation of effect).Intravenous fluids and oxygen are BOTH considered prescribedtherapies.

iii) Outline the expected evaluation criteria or dataand discuss how you would determine that EACH intervention given in(ii) is improving or resolving the identifiedproblem. Support or justify your answers for (i),(ii) and (iii) with peer reviewed, credible, relevant and currentjournal articles.