While caring for a 4-year-old, the nurse uses which tool to assess pain?

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.

Choice A reason: This response is not appropriate because it does not address the mother's concern about antibiotics. It also implies that the nurse is making a medical decision for the child, which is beyond the scope of practice.

Choice B reason: This response is not appropriate because it does not provide any reassurance or education to the mother. It also sounds dismissive of the child's condition and the mother's worry.

Choice C reason: This response is not appropriate because it undermines the authority and judgment of the pediatrician. It also creates doubt and confusion in the mother's mind about the quality of care her child is receiving.

Choice D reason: This response is appropriate because it explains the rationale for not prescribing antibiotics for an ear infection. It also educates the mother about the difference between viral and bacterial infections and the appropriate use of antibiotics.