The nurse would suggest the parents of an asthmatic child to encourage participation in which sport(s)? (Select all that apply.)

Choice A rationale

Room temperature water is optimal for hydration in asthmatic children because it is less likely to trigger bronchospasm. Cold fluids can irritate the sensitive airways and cause constriction of the smooth muscles surrounding the bronchioles, exacerbating respiratory symptoms in individuals with reactive airways like asthmatics.

Choice B rationale

Carbonated beverages are generally not recommended for asthmatic children. The carbonation can cause bloating and discomfort, potentially leading to increased pressure on the diaphragm and exacerbating breathing difficulties. Additionally, the sugars and artificial ingredients in some carbonated drinks may not be ideal for overall health.

Choice C rationale

Iced fruit juice, similar to other cold beverages, can induce bronchospasm in susceptible individuals with asthma. The cold temperature can trigger airway hyperreactivity, leading to narrowing of the airways and worsening of asthmatic symptoms. Therefore, it is best to avoid very cold drinks.

Choice D rationale

Cold milk, like other cold beverages, can potentially trigger bronchoconstriction in asthmatic children due as it can irritate sensitive airways. Furthermore, some individuals with asthma may have co-existing milk allergies or sensitivities that can exacerbate respiratory symptoms, making it a less optimal choice.

Choice A rationale

A peak flow meter measures the maximum speed of exhalation, providing information about airflow obstruction and lung function. While useful for monitoring asthma control, it does not address the patient's difficulty coordinating MDI activation with breathing. It's a diagnostic tool, not a coordination aid.

Choice B rationale

A spacer device is a valved holding chamber that attaches to the MDI. It simplifies inhalation by holding the aerosolized medication, allowing the patient to inhale it slowly and deeply without requiring precise coordination between activation and inspiration. This significantly improves drug delivery to the lungs.

Choice C rationale

Notifying the prescriber that the patient is unable to use the MDI without suggesting solutions is premature. The nurse should first attempt an intervention to resolve the coordination issue, such as suggesting a spacer, as this is a common problem with a well-established solution.

Choice D rationale

While some respiratory medications can be given orally, switching the route of administration should not be the initial intervention for MDI coordination issues. Oral administration can have different pharmacokinetic profiles, systemic side effects, and may not provide the same targeted drug delivery to the airways as inhaled therapy.