A school-age child with asthma came to the emergency department ...

[yoooooman]

A school-age child with asthma came to the emergency department with a respiratory rate of 44 breaths/minute and wheezes heard throughout.
 
  After two breathing treatments, the nurse assesses a respiratory rate of 8 breaths/minute and hears no wheezing. The child is lying quietly on the bed. What action by the nurse is best?
  A.
  Allow the child to rest undisturbed.
  B.
  Call for another respiratory treatment.
  C.
  Obtain oxygen saturation; notify provider.
  D.
  Reassess the child in 30 minutes.

Question 2

A nurse is listening to a school-age child's heart sounds and hears an abnormal noise after S2 that is heard best when the child is lying in the left lateral position. What action by the nurse is most appropriate?
 
  A.
  Arrange a cardiology consult.
  B.
  Document the findings in the chart.
  C.
  Notify the provider immediately.
  D.
  Perform assessments for fluid balance.

[chereeb]

Answer to Question 1

ANS: C
This respiratory rate is too low for a child of any age and is indicative of exhaustion and the inability to breathe effectively. The absence of wheezes may indicate lack of ventilation. The nurse should obtain an oxygen saturation and notify the provider immediately. Without action, the child could progress to respiratory arrest. There is no indication that the child needs another breathing treatment.

Answer to Question 2

ANS: B
This sound is an S3 and is often heard in children and young adults. It is usually a benign finding but should be documented in the chart. A cardiology consult is not needed, nor does the nurse need to notify the provider immediately. Because this sound is not usually associated with heart disease, the nurse does not need to perform an assessment of fluid balance.