Pediatric Asthma
I. Clinical Relevance/Significance
History of Present Problem:
Jared is a 10 year-old African-American boy with a history of moderate persistent asthma. He is being admitted to the
pediatric unit of
...
Pediatric Asthma
I. Clinical Relevance/Significance
History of Present Problem:
Jared is a 10 year-old African-American boy with a history of moderate persistent asthma. He is being admitted to the
pediatric unit of the hospital from the walk-in clinic with an acute asthma exacerbation. Jared started complaining of
increased chest tightness and shortness of breath one day prior to admission. He has been at 50% of his personal best
measurement for his peak expiratory flow (PEF) meter reading which did not improve with the use of albuterol metered
dose inhaler (MDI) (per his written asthma management plan).
In the walk-in clinic Jared is alert, speaking in short sentences due to breathlessness at rest. He has coarse expiratory
wheezes throughout both lung fields with decreased breath sounds at the right base. His oxygen saturation on room air is
90%. His color is pale and he has dark circles under his eyes. He is sitting upright and using his accessory chest muscles
to breath and has moderate intercostal and substernal retractions. He is complaining of tightness in his chest. Jared was
diagnosed with asthma at age 6 years and has 3 prior hospitalizations for asthma with one admission to the pediatric
intensive care unit. He has never had to be intubated with these episodes.
Personal/Social History:
He is accompanied by his mother and 16-year-old sister. Jared lives with his mother, maternal grandmother and sister
in an older housing development in the inter-city. He is in the 5th grade and a good student despite 2-3 absences per
school year for his asthma. He likes to ride his bike and is the goalie on the soccer team. He says that he has lots of
friends at school and likes his teacher Mr. Bates who is also his soccer coach. Both Jared and his mother deny tobacco
smoke at home
[Show More]
