Question: SITUATION: L.S. Is A 7-year-old Who Has Been Brought To The Emergency Department (ED) By His Mother. She Immediately Tells You He Has A History Of ED Visits For His Asthma. He Uses An Inhaler When He Wheezes, But It Ran Out A Month Ago. She Is A Single Parent And Has Two Other Children At Home With A Babysitter. Your Assessment Finds L.S. Alert, Oriented, …
SITUATION: L.S. is a 7-year-old who has been brought to theemergency department (ED) by his mother. She immediately tells youhe has a history of ED visits for his asthma. He uses an inhalerwhen he wheezes, but it ran out a month ago. She is a single parentand has two other children at home with a babysitter. Yourassessment finds L.S. alert, oriented, and extremely anxious. Hiscolor is pale, and his nail beds are dusky and cool to the touch;other findings are heart rate 136 beats/min, respiratory rate 36breaths/min regular and even, oral temperature 37.3° C (99.1° F),SaO2 89%, breath sounds decreased in lower lobes bilaterally andcongested with inspiratory and expiratory wheezes, prolongedexpirations, and a productive cough.
1. As you ask Ms. S. questions, you note that L.S.’srespiratory rate is increasing; he is sitting on the side of thebed, leaning slightly forward, and is having difficulty breathing.Give interventions are appropriate at this time and rationalizeit.
2. Identify the nursing responsibilities associated withgiving bronchodilators.
3. He improves and 24 hours later is transferred to the floor.Asthma teaching is ordered. You assess Ms. S.’s understanding ofasthma and her understanding of the disorder L.S. tells you that heloves to play basketball and football and asks
you whether he can still do these activities. How will yourespond?
4. What additional information should be included in yourdischarge teaching regarding how to prevent acute asthmaticepisodes and how to manage
symptoms of exacerbation of asthma
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