Hey everyone. My name is Abby. We’re going to cover a case study today about pediatric asthma. Let’s get started. Anthony is a six year old male patient brought to the ER with a history of asthma. Since he came home from the NICU as an infant, he has lived with his parents, Bob and Josh, who adopted him after fostering him from the age of four months old. They have tried the usual nebulizer treatments, but Anthony is not responding as usual. So they brought him in for evaluation. Upon initial assessment, Anthony’s lungs had both expiratory and inspiratory wheezes, dyspnea, tachypnea, diaphoresis, and retractions. Let’s take a look at his vital signs:

his blood pressure is 70/40 mmHg heart rate of 131 beats/minute, respiratory rate of 32 beats per minute, oxygen saturation of 93% on room air, with a temp of 38.3 degree Celsius. Now that we’ve looked at this information, let’s look at our critical thinking checks number one and two below.

Great job. Anthony is pale, but not gray. His lips do indicate a very faint, bluish tinge. He can speak, but it does appear difficult. Now that we have these results, let’s take a look at critical thinking checks number three and four below.

Excellent job. After administration of albuterol, Anthony now has a respiratory rate of 22 breaths per minute and an oxygen saturation of 95% on room air. However, the provider does decide to admit him to the inpatient pediatric observation unit. His parents ask if there are ways to keep him from continually being admitted to the hospital. Let’s take a look at critical thinking check number five below.

Great job. Upon admission to the inpatient unit, Anthony rests quietly without worsening respiratory distress signs. The inpatient unit nurse has assessed the patient and prepares to administer oral prednisone. With this in mind, let’s take a look at critical thinking check number six.

Great job looking at those critical thinking checks. Anthony sleeps during the night shift and the next day, his pediatrician makes rounds and discusses a change in the severity rating of Anthony’s asthma. With this in mind, let’s take a look at critical thinking check number seven below.

Great work on those critical thinking checks. Bob and Josh are interested in meeting with respiratory therapy for assistance with inhalers. They say that Anthony has trouble using inhaler devices. With this in mind, let’s take a look at critical thinking check number eight below.

Great job. After lunch, Anthony is ready to be discharged. His parents verbalized gratitude for the staff and thanked the team for helping with education. With this in mind, let’s take another look at the critical thinking checks. This is number nine below.

Great job, everyone! This wraps up our case study on pediatric asthma. Please take a look at the attached study tools and test your knowledge with practice quiz. We love you guys, now go out and be your best self today and as always, happy nursing!

References:

Asthma in children younger than 12 years: Overview of initiating therapy and monitoring control
Authors:Gregory Sawicki, MD, MPHKenan Haver, MD update May, 2021; Patient education: Asthma treatment in children (Beyond the Basics)
Authors:Gregory Sawicki, MD, MPHKenan Haver, MD update Nov 2021; Treatment of intermittent and mild persistent asthma in adolescents and adults
Author:Christopher H Fanta, MD, updated Sept, 2021