Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
The case study
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
Appreciate (E2) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient’s condition across the lifespan.
DIRECTIONS:
1. Read the following critical thinking case study related to Pediatric Asthma
2. Use your critical thinking skills to develop your answers to the 5 questions.
3. Responses should include evidence from scholarly resources.
4. Scholarly writing (proper grammar and use of APA for any text citing and references should be used
5. Critical Thinking assignment is due per course calendar.
6. Review the grading rubric to make sure you complete the assignment accurately.
A three year old comes in with a complaint of coughing for 2 weeks. Coughing is present every night. He has also had a mild fever, but his temperature has not been measured at home. His parents have been using a decongestant/antihistamine syrup and albuterol syrup which were left over from a sibling. Initially the cough improved but it worsened over the last 2 days. He is noted to have morning sneezing and nasal congestion. There are colds going around the pre-school. He has had similar episodes in the past, but this episode is worse. He has no known allergies to foods or medications.
His past history is notable for eczema and dry skin since infancy. He is otherwise healthy and he is fully immunized. His family history is notable for a brother who has asthma. In his home environment, there are no smokers or pets.
Exam: VS T 100.5 F (38.1C), P 100, RR 24, BP 85/65, oxygen saturation 99% in room air. He is alert and cooperative in minimal distress if any. His eyes are clear, nasal mucosa is clear discharge. He has multiple small lymph nodes palpable in his upper neck. Rhonchi and occasional wheezes are heard on auscultation, but there are no retractions. Heart is in a regular rhythm and no murmurs are heard. His skin is dry, but not flaky.
He is initially felt to have moderately persistent asthma and possible asthmatic bronchitis. He is initially treated with nebulized albuterol and nebulized corticosteroids for bronchospasm and bronchial inflammation. He is also treated with an antihistamine at night to reduce his morning allergy symptoms. In follow-up, his cough does not improve and he is still having fever (T 101 F (38.2C)). A chest X-ray is obtained, but no radiographic evidence of pneumonia is present. His cough persists, but only with exercise and drinking cold juice.
His chest now sounds clear in the office. After one week of no night cough, his nebulized albuterol+corticosteroid is reduced to 2 times a day. His exercise induced cough gradually resolves. His nebulized corticosteroid is replaced with nebulized cromolyn twice a day and oral montelukast (a leukotriene inhibitor) is added. He enrolls in a soccer league and plays with minimal coughing. His routine nebulized albuterol+cromolyn is stopped and is used only pre-exercise to prevent exercise induced bronchospasm. No cough is observed at night or with exercise. He is continued on nightly antihistamines, pre-exercise albuterol+cromolyn nebs, and once daily montelukast. He is given an asthma treatment plan which gives his parents clear instructions on which medications to start based on his symptoms and severity.
Critical Thinking Questions
1. How can you best describe asthma? (Asthma description)
2. Describe the various medications to treat asthma? (Asthma treatment, short term medication, long term medications)
3. Describe clinical findings signifying the severity of an acute asthma exacerbation. (Acute asthma exacerbation)
4. Discuss the pros and cons of corticosteroid use in children. (Corticosteroid use, pros and cons)
5. What would you teach the parents of asthmatics in the use of medications, environment, triggers, and life style? (Education, use of medications, environment, triggers, and lifestyle).
