After administering the albuterol to the 12year-old, you evaluate ...

[maychende]

After administering the albuterol to the 12year-old, you evaluate for any response to the treatment. Which finding will you report immediately to the health care provider?
 
  A. Blood pressure 158/88 mm Hg
  B. Apical pulse rate of 160 beats/min
  C. Hand tremors and generalized shakiness
  D. Absent wheezes and decreased breath sounds

Question 2

After a 12-year-old girl had been admitted to the hospital for treatment of status asthmaticus, she has a follow-up appointment at the clinic. What are the important asthma management teaching points to review with the patient and her parents?
 
  What will be an ideal response?

[CharlieArnold]

Answer to Question 1

D

Answer to Question 2

Important Points:
 Asthma is a chronic disease with periods of exacerbation; the goal is to avoid exacerbations and maintain the child's activities at a normal level. Emphasize that prevention of acute asthma symptoms usually requires daily use of controller medications, even when the patient is asymptomatic.
 Teaching and asthma management planning must consider the patient's treatment preferences, as well as the parents'. Teaching should emphasize short-term goals (e.g., ability to participate in activities that the patient enjoys) and include ways the patient can incorporate asthma management into her life while still maintaining peer relationships.
 Factors that cause asthma symptoms (airway hyperresponsiveness, inflammation, and bronchoconstriction)
 Ways to control asthma triggers (vary for each patient but include smoke, dust, exercise, stress, medications, foods, pets)
 Medication review: names and doses; how frequently and when to take medications; side effects; how to use inhalers, spacers, and nebulizers. Emphasize having an adequate supply of all medications at all times.
 Purpose and importance of peak flow monitoring
 Written asthma management plan developed with parents and patient that includes recognition of symptoms indicating worsening asthma along with actions to take and medications to use for the green, yellow, and red zones