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.
QUESTIONS:
1. As you ask Ms. S. questions, you note that L.S.’srespiratory rate is increasing; he
is sitting on the side of the bed, leaning slightly forward,and is having difficulty
breathing. Give interventions are appropriate at this time andrationalize it.
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 of asthma and herunderstanding of
the disorder L.S. tells you that he loves to play basketballand 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 asthmatic episodes and how tomanage
symptoms of exacerbation of asthma?
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