Instructions: Read the case study discussion, then answer the questions below.  Your initial response should be 200 words or more; and 100 words or more to peers. References are required in APA format, you may use your textbook,  journals, or reputable internet resources as references. Awarded points will be significantly lowered if discussion threads are without references in the initial response or replies to peers.


Pediatric Case Study

Scenario history: Johnny is 6 years old, admitted late yesterday with exacerbation of asthma. Johnny has a history of asthma for 2 1/2 years. He has been admitted to the hospital exacerbation x3; no ICU admission. He was admitted due to coughing, exspiratory wheezing, runny nose and increasing shortness of breath that began shortly after a low-grade fever;

Presenting signs: Temp 100.4, HR; 112, RR; 28, 02 Sat 91%

Exspiratory wheezing, intercostals, and subcostal retractions; unable to complete a sentence without shortness of breath.

Peak flow meter- 60%.

  1. What are the nurse’s priorities for this patient?
  2. What symptoms and signs should alert the nurse to potential problems that might need immediate intervention?
  3. What instructions would you give a patient in using a MDI?
  4. What instructions would you give to perform a peak flow reading?
  5. Johnny is unable to use a MDI, what would you suggest to the doctor to order.
  6. What would you include in an Asthma Action Plan for Johnny?
  7. What are B-2 Agonists and Corticosteroids commonly used in treatment of asthma?

B-2 Agonists (Bronchodilators)


Albuterol sulfate (Ventolin ®) is a short-acting beta2-agonist (bronchodilator) administered by nebulizer or spacer. This medication is used intermittently, as needed, during acute exacerbations of the disease.  

Corticosteroids act by reducing swelling and mucus production in the airways. As a result, airways are less sensitive and less likely to react to triggers (Potter, 2010).The Expert Panel (2007) recommends that long-term control medications be taken on a long-term basis to achieve and maintain control of persistent asthma, and that inhaled corticosteroids (ICS) are the most potent and consistently effective long-term control medication for asthma.

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