Question Use The following information to fill in the concept map.

Question Use The following information to fill in the concept map. Rubric at the end Eight year old Tommy Hill was admitted last night with wheezing, difficulty in breathing, and coughing. He was anxious and restless. He was accompanied by his mother who stated, “This always happens when he gets a cold.” Tommy has had numerous lung related illnesses requiring hospitalization during the last two years. This is his third visit this month to the emergency room with an asthma attack. His mother has remained with him all night, but as the nurse enters the room today, she says, “I’ll be back in a second, I have to have a cigarette.” 1. What data does the nurse need today during the interview and the initial morning assessment?Risk factors of Tommy to have an asthma attackIs he taking any medicationsPast medical historyPast hospitalization or surgeryKnown food and drug allergies2. What are possible asthma triggers Tommy and his mother need to be aware of?Tobacco smokeDust mitesOutdoor air pollutionPestMoldCleaning and disinfectionAerosol Ventolin treatments have been decreased from every hour to every four hours. Oral Prelone: 1 tsp TID PO is started this morning. O2 saturation is 94% room air. Rhonchi are scattered throughout the lung field. 3. What effect do Ventolin and Prelone have on Tommy’s lungs and what side effects should the nurse be watching for?’Help lung muscles to relaxOpen airways to let air move in and out of lungs more freelyWatch for headaches, mouth and throat dryness or irritation, changes in taste, cough, nausea or dizziness4. What evaluation criteria would indicate improvement in his condition?He will experience very few symptoms throughout the day and nightPerform daily activities without chest tightness, SOB, coughing or wheezing5. If improvement does not occur and he progresses to status asthmaticus, what should the nurse anticipate happening? Expect possible increase in O2 cannulation as O2 SAT decreasesGlucocosteriods for asthmaticusTommy improves and is ready for discharge tomorrow. The nurse has scheduled a time with the mother to discuss how she can help Tommy prevent future attacks and better care for him as he learns to cope with this disease. In working with Tommy’s mother during hospitalization, the nurse learns that his mother is a visual learner and appears to be somewhat slow in grasping the material. Tommy will be on Ventolin and albuterol MDI along with a spacer and daily monitoring of his peak expiratory flow rates (PEFR). 6. How would you provide education on the pathophysiology of asthma to Tommy’s mother since she is a visual learner? Provide video presentationProvide notes for the mother 7. How could you best teach Tommy’s mother about his medications, asthma triggers, and care during his attacks? Provide visual presentation and simple written instructions on how and why medication should be taken 8. Tommy’s mom asks why she will use the spacer with the medicine he breathes in. Explain the purpose of a metered-dose inhaler (MDI and spacer.) Get a dose of medication into the child’s lungs9. Place the steps of using the MDI with the spacer in the correct order (1 = first step, 6 = last step)a. Depress the top of the inhaler to release medication, and breathe in slowly for 3 to 5 seconds, holding the breath for 5 to 10 seconds at the end of inspiration.b. Shake the inhaler and attach to the spacer.c. Wait 1 to 2 minutes between puffs if more than 1 puff of the same medication is ordered.d. Remove and exhale through the nose.e. At the end of expiration, place mouthpiece into the mouth, forming an airtight seal.f. Tilt the head back and exhale completely.B, F, E, A, D, C10. How much responsibility can Tommy assume for his own disease management?Tommy will have to learn to use MDILearn to avoid his triggersState diagnosis or reason for current hospitalization.All labs, tests and procedures performed during current hospital stay are documented with results and dates.  Include labor and postpartum patients, prenatal labs if available.For pediatric patients include three developmental tasks on the mini concept mapAll current medications prescribed, including PRN, are documented with dosages, frequency and rationale for use.4 nursing diagnosis (one risk for is ok) with 4 evidenced based interventions each.1 short term and 1 long term goal for each nursing dx with evaluation of outcome.Medication and labs are not limited to what’s listed. Whatever else that should be done, can be added as well Health Science Science Nursing NRSG 207 Share QuestionEmailCopy link Comments (0)

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