Asthmatic 8yo male
chief complaint
difficulty breathing
Medical/surgical hx
asthma
prior hospitalizations due to asthma attack
signs/ symptoms
coughing
difficulty breathing
wheezing
chest pressure
fast heart rate
pathophysiology
Airway inflammation
intermittent airway obstruction
bronchial hyperresponsiveness
assessment
Expiratory wheezing
inspiratory wheezing
Intercostal sites of retraction
speaking in partial sentences
Nursing diagnosis
Ineffective airway clearance related to increased production of mucus and bronchospasm.
Patient will maintain clear, open airway as evidence by normal breathe sounds, normal rate and depth of respirations and ability to cough up secretions after treatments.
-teach patient proper ways to cough. Take deep breathe hold for 2 seconds and then cough 2 or 3 times.
-position patient upright
-encourage patient to increase fluid intake
-use of incentive spirometry
-educate patient on optimal positioning
-provide suctioning as needed
Impaired gas exchange related to altered delivery of inspired oxygen
Patient will have improved o2 saturations by the end of shift.
-position patient in semi fowlers position
-monitor o2 saturations
-administer humidified oxygen as prescribed
-encourage slow deep breathing
-administer medications as prescribed
medications
Proventil (albuterol)
treat bronchospasms
Flovent HFA (fluticasone)
prevent symptoms of asthma, reduces swelling in the airway taken daily
Dexamethasone (Ozurdex)
used to treat inflammation