An 8-year-old child, who has a history of asthma, is seen in the office of the school nurse with coughing and wheezing. Which of the following actions should the nurse perform first?

Notify the child's parents of his condition.

Educate the child to avoid triggers.

Transport the child to the emergency department.

Assess the child's peak expiratory flow and compare it to the Asthma Action Plan.

Answer and Explanation

The Correct Answer is D

Choice A reason: Notifying the child's parents of his condition is important, but it is not the first action that the nurse should take. The nurse should prioritize the child's immediate needs and assess his respiratory status.

Choice B reason: Educating the child to avoid triggers is a preventive measure that can help reduce the frequency and severity of asthma attacks, but it is not helpful in an acute situation. The nurse should focus on providing relief and monitoring the child's response.

Choice C reason: Transporting the child to the emergency department may be necessary if the child does not respond to the initial interventions or if his condition worsens, but it is not the first action that the nurse should take. The nurse should first attempt to manage the child's symptoms in the office using the Asthma Action Plan.

Choice D reason: Assessing the child's peak expiratory flow and comparing it to the Asthma Action Plan is the first action that the nurse should take. This will help the nurse determine the severity of the child's asthma attack and the appropriate steps to follow. The Asthma Action Plan is a written document that provides individualized instructions for managing asthma based on the child's symptoms and peak flow readings.

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Correct Answer is A

Explanation

Choice A: 100 mg PO q8 hours - This would give a total of 300 mg per day. Given the child's weight of 11 kg, this results in a dosage of about 27 mg/kg/day, which is within the safe range of 20-40 mg/kg/day.

Choice B: 350 mg PO q8 hours - This would give a total of 1050 mg per day. This results in a dosage of about 95 mg/kg/day, which is more than twice the upper limit of the safe range.

Choice C: 220 mg PO q8 hours - This would give a total of 660 mg per day. This results in a dosage of about 60 mg/kg/day, which is above the safe range.

Choice D: 500 mg PO q8 hours - This would give a total of 1500 mg per day. This results in a dosage of about 136 mg/kg/day, which is more than three times the upper limit of the safe range.

Therefore, the only safe dosage among these options is 100 mg PO q8 hours. Always remember to double-check dosages and consult with a healthcare professional if you're unsure. Safety is paramount when it comes to medication administration.

A. Use self-parent report, behavioral, and physiological factors. B. Ask the parents for a pain rating. C. Look for behavioral clues for pain such as crying. D. Use measures of heart rate and respiratory rate.

Correct Answer is A

Explanation

Choice A reason: This is the most comprehensive and accurate way of assessing a child's pain, as it takes into account the child's own perception, the parent's observation, and the objective signs of pain.

Choice B reason: This is not the best approach, as the parents may not be able to accurately rate the child's pain, especially if the child is too young or has communication difficulties.

Choice C reason: This is not the best approach, as behavioral clues may not always reflect the intensity or quality of pain, and may be influenced by other factors such as fear, anxiety, or coping strategies.

Choice D reason: This is not the best approach, as physiological measures may not always correlate with pain, and may be affected by other variables such as medication, stress, or illness.

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An 8-year-old child, who has a history of asthma, is seen in the office of the school nurse with coughing and wheezing. Which of the following actions should the nurse perform first?

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