Republic of the Philippines

CAMARINES SUR POLYTECHNIC COLLEGES

Nabua, Camarines Sur
College of Health Sciences

PEDIATRIC CASE STUDY:

ASTHMA SITUATION: Valerie, age 15 years, is brought to the Our Lady Mediatrix Hospital ER by her
mother. Valerie is in acute respiratory distress. Her mother informs the nurse that Valerie has had
multiple hospital admissions related to asthma. Valerie does not respond to the usual treatment while
she is in the ER. She is admitted to the pediatric unit with a diagnosis of acute asthma.

1. List the clinical manifestations of asthma that Valerie might exhibit.

 Difficulty of breathing
 Chest tightness
 A whistling or wheezing sound when breathing out

2. The nurse starts an IV to provide fluids and medications for Valerie. Aminophylline is added to the
IV. What are common side effects valerie might experience with the use of this drug? What nursing
measures are implemented with the use of aminophylline?
 Aminophylline injection is used together with other medicines to treat the acute symptoms of
asthma, bronchitis, emphysema, and other lung diseases in a hospital setting. You may
experience these side effects: Nausea, loss of appetite (taking this drug with food may help if
taking the immediate-release or liquid dosage forms); difficulty sleeping, depression,
emotional lability (reversible). Report nausea, vomiting, severe GI pain, restlessness,
seizures, irregular heartbeat
3. The nurse review asthma triggers with Valerie and her mother. List factors that might precipitate an
asthma attack.
Some known triggers of asthma attacks include:

 Allergies
 Food and food additives
 Exercise
 Heartburn
 Smoking
 Sinusitis
 Medications
 Weather
 Smoke

4. The nurse’s first-priority nursing diagnosis is: impaired gas exchange related to narrowing of the
bronchial lumen by spasm, edema, and secretions. What goal will the nurse establish and what
nursing interventions will the nurse utilize to meet this goal?
Impaired gas exchange is a disruption of the oxygen and carbon dioxide exchange in the lung tissues.
This nursing diagnosis can be a serious health threat usually closely associated with other nursing
diagnoses like ineffective breathing pattern or ineffective airway clearance. Assess for lung sounds for
indications of atelectasis , Check vital signs every 15 minutes and assess for changes in heart rate and
blood pressure , Use a continuous pulse oximeter to monitor oxygen saturation , Administer 2 liters per
minute of oxygen through a nasal cannula as ordered, Assess the patient’s willingness to refer to
pulmonary rehabilitation.

5. List four other nursing diagnoses which would be appropriate for Valerie while she is hospitalized.
 Ineffective Breathing Pattern.
 Ineffective Airway Clearance.
 Deficient Knowledge.
 Anxiety.
 Activity Intolerance.

6. Make a list of items to be included in a teaching plan to provide for self-management of asthma

 Techniques to deal with problems such as frustration, fatigue, pain, and isolation.
 Appropriate exercise for maintaining and improving strength, flexibility, and endurance.
 Managing depression.
 Appropriate use of medications.
 Communicating effectively with family, friends, and health professionals.
 Healthy eating habits.
 Better breathing techniques.
 Relaxation techniques.

Submission will be on or before October 29, 2022. 5:00 PM

Thank you and keep safe everyone. . .

VALERIE SHEILA M. BERNALES, RN,JD

Clinical Instructor