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Asked by MegaApeMaster110

Title: Asthma

 

Scenario: Devon, age 16, was playing soccer during gym class when she suddenly became breathless. Her gym teacher called a time out and Devon moved to the sideline, the nurse was called. Upon arrival to the field, the nurse observed Devon sitting on the bench in a tri-pod position. Her breathing appears labored and the nurse can appreciate an audible expiratory wheeze.

 

Vital signs include: Temperature (temporal) 99.1°F, Pulse 132, Blood pressure 146/92, Respiratory rate 30, O2 saturation 90%.

 

Devon has a medical history significant for asthma, psoriasis, and peanut allergy causing anaphylaxis. Current medications include albuterol HFA 90 mcg/inh 1-2 puffs @ 4-6 hours prn for wheezing or breathlessness, epi-pen autoinjector prn, Advair 100/50 mcg one puff Q 12 hours, betamethasone topical cream 0.05% once daily.

 

The nurse administers the albuterol inhaler and continues her assessment. Cardiac auscultation reveals S1, S2 at a tachycardic rate. Severe inspiratory and expiratory wheezing is present throughout the bilateral lung fields with auscultation. Intercostal retractions are noted with inspiration. Her cheeks appear flushed and she is diaphoretic. A small abrasion is noted on the left shin. Devon states, “I don’t feel like my inhaler is working!.” The nurse instructs the gym teach to call “911.”

 

Item Type: Extended Multiple Response

What objective data from Devon’s assessment indicates a need for immediate medical attention for her asthma? (Select all that apply.)

Tripod positioning
Intercostal retractions with inspiration
Documented history of anaphylaxis
Abrasion left shin
Auscultation S1, S2
Severe inspiratory and expiratory wheezing auscultated in all lung fields
Temperature (temporal) 99.1°F
O2 Sat 90%
Flushed cheeks
Devon states, “I don’t feel like my inhaler is working!.”
SCIENCE
HEALTH SCIENCE
NURSING
NR 304

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