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 reason: A peak expiratory flow meter is a device that measures how fast the child can exhale air from the lungs. It can help monitor the severity of asthma and the effectiveness of treatment. It can also help identify triggers and prevent asthma attacks.

Choice B reason: A metered dose inhaler with spacer is a device that delivers medication to the lungs. It can help relieve or prevent asthma symptoms, but it does not measure how well the asthma is controlled.

Choice C reason: Pulse oximetry is a device that measures the oxygen saturation of the blood. It can help detect hypoxia, which is a complication of asthma, but it does not measure how well the asthma is controlled.

Choice D reason: Inhaled steroids are a type of medication that reduce inflammation in the airways. They can help prevent asthma attacks and improve lung function, but they do not measure how well the asthma is controlled.

A. Ask the parents to leave so that you can be with the patient alone. B. Tell the parents you suspect the girl might be pregnant. C. Obtain consent for pregnancy testing from the parents. D. Omit the routine pregnancy test since the girl is not sexually active.

Correct Answer is C

Explanation

Choice A reason: This is not appropriate because it may make the parents feel excluded or suspicious. It may also make the girl feel uncomfortable or scared. The parents have the right to be present and involved in their daughter's care, unless they pose a threat to her safety.

Choice B reason: This is not appropriate because it may offend or upset the parents and the girl. It may also damage the trust and rapport between the provider and the family. The provider should not make assumptions or accusations based on the girl's symptoms.

Choice C reason: This is appropriate because it respects the parents' authority and the girl's privacy. It also allows the provider to rule out pregnancy as a possible cause of the abdominal pain, and to offer appropriate counseling and treatment if needed.

Choice D reason: This is not appropriate because it may miss a potential diagnosis or complication. The provider should not rely solely on the parents' or the girl's statements about sexual activity, as they may be inaccurate or dishonest. The provider should follow the standard of care and perform a pregnancy test for any female of childbearing age with abdominal pain.

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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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