The Pediatric Patient

A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition?

• Warm, dry skin

• Decreased wheezing

• Pulse rate of 90 beats/minute

• Respiration of 18 breaths/minute

A mother calls the pediatrician's office requesting an appointment for her 8-year-old child. She states he has asthma and is telling her he had trouble breathing last night and does not want to go to school. In triaging this child, which is the most important question to initially ask the mother?

• "Is your child crying and irritable?"

• "Does your child have a productive cough?"

• "Did he have a temperature last night of greater than 100° F?"

• "Is your child telling you at this time he is having trouble breathing?"

You are caring for a 6-year-old child with asthma. The mother of the patient asks you to explain the pathophysiology of the disease. When explaining what causes the obstruction of the airway you mention (select all that apply):

• Contraction of muscles surrounding the bronchi

• Swelling of bronchial membranes

• Destruction of the alveolar wall

• Thick mucus

A pediatric patient in the ED with acute asthma presents with inspiratory and expiratory wheezes and decreased expiratory volume. Which medication should be given right away?

• Acebutolol

• Prednisone

• Albuterol

• Fluticasone

A nurse is teaching a 9-year-old client with asthma how to use a respiratory inhaler. Which action by the client indicates the need for further teaching?

• The client removes the cap and shakes it well before use

• The client presses the canister down with finger as they breathe in

• The client inhales the mist and quickly exhales

• The client waits 1 - 2 minutes between puffs if more than one puff has been prescribed

The Andrews family has been taking good care of their youngest, Archie, who was diagnosed with asthma. Which of the following statements indicate a need for further home care teaching?

• "He should increase his fluid intake regularly to thin secretions."

• "We'll make sure that he avoids exercise to prevent attacks."

• "He is to use his bronchodilator inhaler before the steroid inhaler."

• "We need to identify what things trigger his attacks."