10/10/20
A 10 yr boy has just been diagnosed w/ asthma related to allergies the nurse is responsible for
discharging the child on montelokast tablet every day, ventolin inhaler. as needed for an
asthma attack nedocromil inhaler once a day.
1. What discharge instructions should the nurse give the mother about the child's
medications?
Your child has asthma, which causes the airways of the lungs to swell and
narrow. Now that your child is going home from the hospital, follow the health
care provider's instructions on how to care for your child.
When you are at the hospital:
In the hospital your child will help of the provider to breath better, they gave
oxygen and medicine to open the airways.
When you are at home:
Your child still have asthma after leaving hospital, you should include the
symptoms:
-wheezes and coughing that may last up to 5 days
-sleeping and eating that may take a week to get normal
Take Charge of Your Child's Asthma at Home
Make sure that you know the asthma of and the peak flow reading of your child
and understand what it means.
-Know your child's personal best number.
-Know your child's peak flow reading that tells you if their asthma is getting
worse.
-Know your child's peak flow reading that means you need to call your child's
Provider.
-Avoid your child from pets, smoke, dust, smell from chemicals, grass and weeds,
cockroaches, rooms that moldy and damp, and activities that may trigger the
asthma.
School and Asthma
They also need a support from school staff to keep their asthma under control and
to be able to do activities and also have an asthma action plan of the people in the
school including
-Teacher
-School nurse
-School office
-Gym teachers and coaches
When to call doctor
Call your child's provider if your child is having any of the following:
Hard time breathing
Chest muscles are pulling in with each breath
Breathing faster than 50 to 60 breaths per minute (when not crying)
Making a grunting noise
Sitting with shoulders hunched over
Skin, nails, gums, lips, or area around the eyes is bluish or grayish
Extremely tired
Not moving around very much
Limp or floppy body
Nostrils are flaring out when breathing
Also call the provider if your child:
Loses their appetite
Is irritable
Has trouble sleeping
1. What explanations should the nurse give the mother about asthma?
Talk about how normal lungs work.
Talk about what happens during an asthma attack.
Talk about the medicine they take (fit to child's medication plan).
Talk about going to the doctor.
Talk about using a peak flow meter.
Talk about triggers (use the triggers that affect your child).
Talk about what to do if the asthma attack or have warning zone
2. What instructions should the nurse give the mother about when to seek immediate
medical attention?
Follow the action asthma plan to prevent attacks.
Take your medicines as prescribe time.
Talk to the child’s doctor before using another medicines.
Avoid smoking area
Avoid the things that your child asthma will trigger
Avoid cold and influenza
3. What should the child know about an asthma attack?
Find it hard to breathe.
Breathe more quickly.
Be unable to talk or walk or eat.
Wheeze and cough a lot.
Complain of a tight chest or a tummy ache.
Say their blue reliever inhaler isn't helping, or they need it more than every four
hours.
Be unusually quiet.
4. What can triggers & how do they affect asthma?
Some triggers that will affect your child’s asthma and make inflammation their
lungs even worse, the common cold is on of the triggers and others include:
-Smoke
-Exposure to allergens (such as animal dander, dust mites or pollen)
-Strong smells (perfumes or other odors)
-Changes in weather; cold air
-Running or playing hard
-Crying or laughing
NURSING CARE PLAN
ASSESMENT DIAGNOSE PLANNING INTERVENTION RATIONALE EVALUATION
Objective: Ineffective After 10 min Assess airway for Maintaining After 10 minute the
airway child will be patency. patent airway is child will be able to
BP: 130/80 clearance able to breath always the first breath normally
related to normally priority
RR-30 bpm inflammation
of bronchi due
PR-12mmhg to allergens
Abnormal
HR-120 bpm breath sounds
can be heard as
fluid and mucus
Auscultate lungs accumulate.
for presence of This may
normal or indicate
adventitious ineffective
breath sounds airway
clearance.
These may
indicate
presence of a
Asses the mucous plug or
decreased or other major
absent breath obstruction
sounds like
wheezing, and This may
coarse crackles indicate partial
airway
obstruction or
resistance.
This
may indicate
presence of
secretions along
larger airways.
Identify the
allergens
Use of nasal
sprays as
prescribed by the
doctor
Encourage
medication
compliance
Educate the
parents about
