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Pediatric Case Study Scenario history: Johnny is 6 years old, admitted late yesterday with exacerbation of...

Pediatric Case Study

Scenario history: Johnny is 6 years old, admitted late yesterday with exacerbation of asthma. Johnny has a history of asthma for 2 1/2 years. He has been admitted to the hospital exacerbation x3; no ICU admission. He was admitted due to coughing, expiratory wheezing, runny nose, and increasing shortness of breath that began shortly after a low-grade fever.

Presenting signs: Temp 100.4, HR; 112, RR; 28, 02 Sat 91%

Expiratory wheezing, intercostal, and subcostal retractions; unable to complete a sentence without shortness of breath.

Peak flow meter- 60%.

  1. Discuss the nurse’s priorities for this patient?
  2. What symptoms and signs should alert the nurse to potential problems that might need immediate intervention?
  3. What instructions would you give a patient in using an MDI?
  4. What instructions would you give to perform a peak flow reading?
  5. Johnny is unable to use an MDI, what would you suggest to the doctor to order.
  6. What would you include in an Asthma Action Plan for Johnny?
  7. What B-2 Agonists and Corticosteroids commonly used in the treatment of asthma?

Solutions

Expert Solution

Discuss the nurse’s priorities for this patient?

  • Asses the breath sounds
  • Asses the respiratory status
  • Assess the peak flow
  • Assess the oxigen saturation by using pulse oximetry
  • Monitor vital signs

What symptoms and signs should alert the nurse to potential problems that might need immediate intervention?

  • Shortness of breath
  • Coughing
  • Running nose
  • Expiratory wheezing
  • unable to complete a sentence without shortness of breath
  • intercostal, and subcostal retractions
  • Elevated temperatures
  • Elevated number of breath per minute

What instructions would you give a patient in using an MDI?

The MDI is a pressurized canister contains medicine in a plastic holder with a mouthpiece. While spraying it gives an adequate consistent dose of medication .

  • Shake the MDI before use
  • Prime the inhalor first
  • As you breathe in deeply, press down for best results
  • After use of MDI , wipe and clean it with a dry cloth .

Nightingale answered 2 years ago
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