HPS Pediatric Asthma Scenario: Molly Higgins with complete solution
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1. 1. What factors may trigger an asthmatic episode?: Can be caused by physical and chemical irritants such as foods (nuts, milk/dairy products), pollens, dust mites, cockroaches, smoke, animal dander
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, temperature changes, respiratory infection, activity and stress.
2. 2. What are the clinical manifestations of a child experiencing an exacerba- tion of asthma?: Child has episodes of wheezing, shortness of breath, dyspnea, chest tightness, decrease in expiratory airflow secondary to bronchospasms, mucosal edema, and mucous plugging, air is trapped behind occluded or narrow airways, and hypoxemia can occur.
3. 3. Explain the progression of asthma that is non-responsive to treatment.-
: Status asthmaticus is respiratory distress despite vigorous treatment measures including albuterol and epinephrine. This is considered a medical emergency that can result in respiratory failure and death if left untreated.
4. 4. Discuss the pathophysiology of asthma.: Includes complex interactions among inflammatory cells, mediators, and cells and tissue present in the airways.
- Another component is bronchospasms obstruction: o Inflammatory response to stimuli o Airway edema and accumulation and secretion of mucus o Spasm of the smooth muscle of bronchi and bronchioles.
5. 5. Discuss the actions, side effects, contraindications, and nursing impli- cations of the following medications in the treatment of asthma: albuterol, Atrovent, epinephrine, prednisolone, prednisone, solumedrol, magnesium sulfate, sodium bicarbonate.:
6. Albuterol: Bronchodilator, SE: chest pain, tremor, palpitations, Contraindica- tions: hypersensitivity to adrenergic amines, Implications: for inhaler shake well use a spacer for children under
7. Atrovent: Inhibits cholinergic receptors in bronchial smooth muscle/ bronchodi- lation, SE: hypotension, sore throat, headache, Contraindications: avoid use during acute bronchospasm/ hypersensitivity to ipratropium, atropine, when ipratropium is administered concurrently with other inhalation medications, administer adrenergic bronchodilators first, wait 5 mins between medications.
8. Epinephrine: These drugs stimulate all the sympathetic receptors, SE: nervous- ness, nausea / vomiting, headaches, palpitations, hypertension. Contraindications: hypersensitivity to adrenergic amines.
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