Jenny is a 36-year-old pregnant woman in her 26th week of pregnancy who has a history of allergies and asthma. She has been experiencing increasing shortness of breath and wheezing over the past 5 days. Her symptoms have progressively worsened, disrupting her sleep and making normal activities difficult. She is now so short of breath that she can barely speak or walk.

1. CASE STUDY
Jenny is a 36 year old woman
currently on her 26th week of
pregnancy. She is presenting SOB
and wheezing for the past couple of
days…
Adaptation based on Asthma Knowledge Questionnaire
(Kolbe, Vamos, James, Elkind & Garrett 2003).
Appendix A

2. Jenny is a 36 years old woman currently
in her 26th week of pregnancy with a history
of allergic rhinitis and seasonal allergies
who appeared more tired for the past
month and has shown progressive shortness
of breath and wheezing for the past
couple of weeks.
During a recent doctors visit, her
primary care physician prescribed an
albuterol asthma pump which she didn’t
use due to fear to harm the baby.
A week later she returned to the same
doctor who in turn prescribed an albuterol
nebulizer treatment along with a nebulizer
machine and some prednisone pills in case
her shortness of breath got worst.
Because of fear to harm the baby
Jenny decided to use the nebulizer
treatment and asthma pump and avoid
the prednisone at all costs.

3. For the last 2 days Jenny have been feeling a little more wheezy and
breathless than usual, but not enough to interfere with her everyday
activities. Last night she woke up once because of shortness of wheezing,
but was able to go back to sleep again easily. This morning she again woke
up feeling more wheezy and breathless than usual. What should she do?
Take a peak flow
reading
Use a beta
agonist/asthma
treatment
Drink hot tea
Take a pulse
oximeter reading
Take OTC
Benadryl to help
sleep
Take oral steroid
Go to the gym/ do
cardio exercise
Take inhaled
steroid if
prescribed
Private transport
to the ER within
24-48 hrs
Private transport
to the ER in less
than 24 hrs if no
steroid
Call Ambulance
Take asthma and
cold homeopathic
medicine
Drive herself to
the ER within 24-
48 hrs
Drive herself to
the ER in less
than 24 hrs if no
steroid
Go to the doctor
by private
transport
Drive herself to
the doctor

4. For the last 2 days Jenny have been feeling a little more wheezy and
breathless than usual, but not enough to interfere with her everyday
activities. Last night she woke up once because of shortness of wheezing,
but was able to go back to sleep again easily. This morning she again woke
up feeling more wheezy and breathless than usual. What should she do?
Take a peak flow
reading
Use a beta
agonist/asthma
treatment
Drink hot tea
Take a pulse
oximeter reading
Take OTC
Benadryl to help
sleep
Take oral steroid
Go to the gym/ do
cardio exercise
Take inhaled
steroid if
prescribed
Private transport
to the ER within
24-48 hrs
Private transport
to the ER in less
than 24 hrs if no
steroid
Call Ambulance
Take asthma and
cold homeopathic
medicine
Drive herself to
the ER within 24-
48 hrs
Drive herself to
the ER in less
than 24 hrs if no
steroid
Go to the doctor
by private
transport
Drive herself to
the doctor

5. It is now 3 days and Jenny has been more short of breath and wheezy. Her
breathing got slightly worse over the last 2 days as she found increasingly
difficult to get on with her daily activities. Last night she was wakened twice
because of SOB and found it difficult to get back to sleep. Today she woke
earlier than usual and is feeling very wheezy and breathless, she won’t take
oral steroids. What should she do?
Take a peak flow
reading
Use a beta
agonist/asthma
treatment
Drink hot tea
Take a pulse
oximeter reading
Take OTC
Benadryl to help
sleep
Take oral steroid
Go to the gym/ do
cardio exercise
Take inhaled
steroid if
prescribed
Private transport
to the ER within
24-48 hrs
Private transport
to the ER in less
than 24 hrs if no
steroid
Call Ambulance
Take asthma and
cold homeopathic
medicine
Drive herself to
the ER within 24-
48 hrs
Drive herself to
the ER in less
than 24 hrs if no
steroid
Go to the doctor
by private
transport
Drive herself to
the doctor

6. It is now 3 days and Jenny has been more short of breath and wheezy. Her
breathing got slightly worse over the last 2 days as she found increasingly
difficult to get on with her daily activities. Last night she was wakened twice
because of SOB and found it difficult to get back to sleep. Today she woke
earlier than usual and is feeling very wheezy and breathless, she won’t take
oral steroids. What should she do?
Take a peak flow
reading
Use a beta
agonist/asthma
treatment
Drink hot tea
Take a pulse
oximeter reading
Take OTC
Benadryl to help
sleep
Take oral steroid
Go to the gym/ do
cardio exercise
Take inhaled
steroid if
prescribed
Private transport
to the ER within
24-48 hrs
Private transport
to the ER in less
than 24 hrs if no
steroid
Call Ambulance
Take asthma and
cold homeopathic
medicine
Drive herself to
the ER within 24-
48 hrs
Drive herself to
the ER in less
than 24 hrs if no
steroid
Go to the doctor
by private
transport
Drive herself to
the doctor

7. It is now 5 days that Jenny has been more short of breath and wheezy. Her
wheezing and breathlessness got worse over the next day. Last night she
wakened three times because of asthma and the last time she could not
get back to sleep. It is now morning and she is so wheezy and breathless
that she finds it difficult to speak or walk across the room. What should she
do?
Take a peak flow
reading
Use a beta
agonist/asthma
treatment
Drink hot tea
Take a pulse
oximeter reading
Take OTC
Benadryl to help
sleep
Take oral steroid
Go to the gym/ do
cardio exercise
Take inhaled
steroid if
prescribed
Private transport
to the ER within
24-48 hrs
Private transport
to the ER in less
than 24 hrs if no
steroid
Call Ambulance
Take asthma and
cold homeopathic
medicine
Drive herself to
the ER within 24-
48 hrs
Drive herself to
the ER in less
than 24 hrs if no
steroid
Go to the doctor
by private
transport
Drive herself to
the doctor

8. It is now 5 days that Jenny has been more short of breath and wheezy. Her
wheezing and breathlessness got worse over the next day. Last night she
wakened three times because of asthma and the last time she could not
get back to sleep. It is now morning and she is so wheezy and breathless
that she finds it difficult to speak or walk across the room. What should she
do?
Take a peak flow
reading
Use a beta
agonist/asthma
treatment
Drink hot tea
Take a pulse
oximeter reading
Take OTC
Benadryl to help
sleep
Take oral steroid
Go to the gym/ do
cardio exercise
Take inhaled
steroid if
prescribed
Private transport
to the ER within
24-48 hrs
Private transport
to the ER in less
than 24 hrs if no
steroid
Call Ambulance
Take asthma and
cold homeopathic
medicine
Drive herself to
the ER within 24-
48 hrs
Drive herself to
the ER in less
than 24 hrs if no
steroid
Go to the doctor
by private
transport
Drive herself to
the doctor

9. References:
Kolbe, J., Vamos, M., James, F., Elkind, G., & Garrett, J. (2003). Asthma Knowledge
Questionnaire. In B. K. Redman, Measurement Tools in Patient Education (pp. 155-
159). New York, NY: Springer Publishing Company.