HESI Case Studies: Pediatrics – Asthma – Flashcards
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Which of the school nurse's observations are consistent with the diagnosis of bronchitis?
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A dry cough that becomes productive.
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Jamey's mother asks the school nurse to explain the pulmonary function test. Which of the following is the best response?
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"Pulmonary function tests are used to detect airflow limitation even when no symptoms are clinically evident."
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Since Jamey has moderate persistent asthma, which symptoms can the school nurse expect at baseline (with no treatment), if Jamey fails to adhere to controller medication use?
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Nighttime cough more than once a week but not nightly.
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In developing plan of care goals, the school nurse recognizes that what level of activity is appropriate for children with asthma?
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Children with asthma should participate fully in all activities, including sports.
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What measures can the school nurse take to ensure a trigger-free classroom environment?
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Eliminate all sources of dust in the classroom.
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The school nurse recognizes that Jamey is using correct inhaler technique when Jamey does which?
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He holds his breath for 10 seconds after inhaling the medication.
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How should the school nurse intervene?
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Discuss Jamey's treatment plan with his mother and emphasize the benefits of controller medication.
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The school nurse monitors Jamey for response to albuterol. What response might the nurse expect to observe?
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Rapid heart rate.
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Which of the following signs would alert the RN that respiratory arrest is imminent?
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Rapid respirations with no wheezing.
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What additional emergency medication should the RN anticipate preparing?
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Methylprednisolone sodium succinate IV
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Which of the following is a correct interpretation of Jamey's current PEFR reading
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Jamey is in the red zone. There is severe airway narrowing.
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In preparing the SBAR report to the unit staff, what are the priority data points the ED RN must communicate?
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Acute asthma exacerbation precipitated by an upper respiratory infection, PEFR reading, medications given with response to treatment, and respiratory assessment.
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Which of the following nursing diagnoses best describes the underlying pathophysiologic process for a child with an acute asthma exacerbation?
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Ineffective airway clearance related to inflammation and constriction of the bronchial tree.
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What are the highest priority acute care nursing interventions for the RN to include in Jamey's plan of care?
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Frequent vitals signs with pulse oximetry monitoring, assessing response to medication.
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Using knowledge of child development, the RN interprets Jamey's behavior as which?
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Appropriate for age in a preschooler.
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Which of the following would be an appropriate play activity for Jamey to express his feelings?
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Drawing and painting.
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Based on knowledge of asthma as a chronic inflammatory disease, in this case complicated by allergic rhinitis, what is the best response of the RN?
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Asthma is not truly outgrown, but we will teach you measures to control symptoms so that Jamey can lead a normal life.
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What are the client education priorities during the acute care phase?
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How to use the inhaler with spacer. Parental recognition of early warning signs. Reducing the risk of upper respiratory tract infections. Controller and rescue medication use.
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Which of the following is the best intervention for the RN to implement to assure partnership with both parents and continuity of care on weekends?
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Request an educational session with both parents in the primary pediatric care setting.
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The RN should stress which of the following as early signs of impending asthma attack?
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Cough in the middle of the night?
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Which of the following is the correct method of assessing the level of medication in the inhaler?
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Count and record the number of inhalations used.
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Which of the following strategies should the RN address to reduce exposure to airborne allergens in the home?
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Focus on eliminating dust in the room where Jamey sleeps. Remove trash daily. Stop smoking. Eliminate clutter.
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Which of the following would be the best strategy?
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Teach Jamey to blow a pin wheel.
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The response of the RN is based on what knowledge about salmeterol xinafoate?
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Salmeterol xinafoate cannot be used to treat acute symptoms.
