HESI Case Studies: Pediatrics – Asthma – Flashcards

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