A 6-year-old child is in the hospital for status asthmaticus. ...

[Redwolflake15]

A 6-year-old child is in the hospital for status asthmaticus. Nursing care during this acute period includes which prescribed interventions?
 
  a. Prednisolone (Pediapred) PO every day, IV fluids, cromolyn (Intal) inhaler bid
  b. Salmeterol (Serevent) PO bid, vital signs every 4 hours, spot check pulse oximetry
  c. Triamcinolone (Azmacort) inhaler bid, continuous pulse oximetry, vital signs once a shift
  d. Methylprednisolone (Solumedrol) IV every 12 hours, continuous pulse oximetry, albuterol nebulizer treatments every 4 hours and prn

Question 2

A 3-month-old infant is admitted to the pediatric unit for treatment of bronchiolitis. The infant's vital signs are T, 101.6 F; P, 106 beats/min apical; and R, 70 breaths/min. The infant is irritable and fussy and coughs frequently.
 
  IV fluids are given via a peripheral venipuncture. Fluids by mouth were initially contraindicated for what reason?
  a. Tachypnea
  b. Paroxysmal cough
  c. Irritability
  d. Fever

[moormoney]

Answer to Question 1

ANS: D
The child in status asthmaticus should be placed on continuous cardiorespiratory (including blood pressure) and pulse oximetry monitoring. A systemic corticosteroid (oral, IV, or IM) may also be given to decrease the effects of inflammation. Inhaled aerosolized short-acting 2-agonists are recommended for all patients. Therefore, Solumedrol per IV, continuous pulse oximetry, and albuterol nebulizer treatments are the expected prescribed treatments. Oral medications would not be used during the acute stage of status asthmaticus. Vital signs once a shift and spot pulse oximetry checks would not be often enough.

Answer to Question 2

ANS: A
Fluids by mouth may be contraindicated because of tachypnea, weakness, and fatigue. Therefore, IV fluids are preferred until the acute stage of bronchiolitis has passed. Infants with bronchiolitis may have paroxysmal coughing, but fluids by mouth would not be contraindicated. Irritability or fever would not be reasons for fluids by mouth to be contraindicated.