Asthma

Talk to her about what medications do and why they are important, show her how to administer the different medications effectively. -Explain what a trigger is and why they need to be avoided. Explain what will happen if they are not avoided and what the results could be. Discuss second hand smoking and the effects that could be having. -Teach her about how to administer emergency medications, how to monitor pulse and respirations during attacks. Teach her to monitor accessory muscles and color, and when to take him to the ER if needed.

How could the nurse best teach Tommy's mother about his medications, asthma triggers, and care during his attacks? -Talk to her about what me

-Administer Racemic Epinephrine immediately.

Often in your career as a nurse, you will be faced with children experiencing emergency situations, such as an asthma attack. I you call the physician to report respiratory distress in the child and he or she responds, "Handle it, I'm busy." What would you do?

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Eight year old Tommy Hill was admitted last night with wheezing, difficulty breathing, and coughing. He is anxious and restless. He was accompanied by his mother who stated, "This always happens when he get a cold." Tommy has had numerous lung related illnesses requiring hospitalization during the last two years. This is his third visit this month to the emergency room with an asthma attack. His mother has remained with him all night, but as the nurse enters the room today, she says, "I'll be back in a second, I have to have a cigarette."

-slowly with him repeating back what she shows him, use pictures and videos

How might the nurse teach Tommy to use the inhaler correctly?

-He can learn when to tell his teacher or mom that he's having tightness or breathing problems.

How much responsibility can Tommy assume for his own disease management?

Immediately administer Racemic Epinephrine for bronchodilation -Possibly administer IV epinephrine

If improvements do not occur and he progresses to status asthmaticus, what should the nurse anticipate would be done?

Second hand smoke Allergens

What are possible asthma triggers Tommy and his mother need to be aware of

Medical History -Where is the pain at in the lungs? -How does it feel? (kind of pain, sharp, dull, etc.) -Aggravating and Alleviating factors (what makes the discomfort worse or better/ what eases breathing) -Timing (when does the shortness of breath start, how long does it last) -Severity of the pain on a scale 1-10 (how bad is the pain, how bad is the shortness of breath?) -Useful other data (do you have asthma attacks outside of the home where you are exposed to second hand smoke?) -Patient perception (how does it make you feel when you have an asthma attack) -Set of vitals -Focused assessment on the respiratory system with lung sounds, any noted lung sounds, respirations, level of involvement of accessory muscles, and any discomfort.

What data does the nurse need today during the interview and morning assessment

Ventolin: Bronchodilator, relaxes the smooth muscle -Side effects: chest pain, hypertension, restlessness, nervousness, increased heart rate. -Prelone: steroidal ant inflammatory -Side effects: Hypertension, Cushing, depression, euphoria

What effect to Ventolin and Prelone have on Tommy's lungs and what side effects should the nurse are watching for?

Less use of accessory muscles to breath -higher oxygen saturation -Improved color -Less coughing -Less chest tightness -Less wheezing -Respirations in normal range

What evaluation criteria would indicate improvement in his condition?