Reference no: EM133443767

PEDIATRIC CASE STUDY: ASTHMA 

Laura, age 9 years, is brought to the hospital ER by her mother. Laura is in acute respiratory distress. Her mother informs the nurse that Laura has had multiple hospital admissions related to asthma. Laura does not respond to the usual treatment while she is in the ER. She is admitted to the pediatric unit with a diagnosis of acute asthma. 

1. List the clinical manifestations of asthma that Laura might exhibit. 
2. The nurse starts an IV to provide fluids and medications for Laura. Laura is ordered for a magnesium sulfate bolus via the IV. Why is this ordered? What are common side effects Laura might experience with the use of this drug? What nursing measures are implemented with the use of magnesium? 
3. Laura is also ordered for O2 therapy via Nasal cannula to keep sats greater than 93%. Laura is ordered for albuterol inhaler 6 puffs q 1 hour. You perform a respiratory assessment before and after each administration. What are you looking for? What are some side effects of using that much albuterol? What are some signs that Laura is getting worse? When would you use your resources such as involving the charge nurse, paging the doctor...think about the CHEWS scores we talked about at clinical. What are the signs that she is getting better?
4. Your care and attention has done the trick and Laura is feeling better. Your albuterol is now spaced to 2 puffs q 4 hours and she appears comfortable. Now it is time for discharge teaching.
5. The nurse review asthma triggers with Laura and her mother. List factors that might precipitate an asthma attack. 
6. Laura has been using a Peak Flowmeter to help monitor her breathing capacity. She also uses a metered-dose inhaler. What information does Laura provide that indicates proper use of these treatment modalities? 
7. The nurse's first-priority nursing diagnosis is: impaired gas exchange related to narrowing of the bronchial lumen by spasm, edema, and secretions. What goal will the nurse establish and what nursing interventions will the nurse utilize to meet this goal? 
8. List four other nursing diagnoses which would be appropriate for Laura while she is hospitalized. 
9. Make a list of items to be included in a teaching plan to provide for self-management of asthma.