Pediatric Asthma
FUNDAMENTAL Reasoning
m
er as
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eH w
o.
rs e
ou urc
o
aC s
vi y re
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ar stu
Jared Johnson, 10 years old
Primary Concept
is
Gas Exchange
Interrelated Concepts (In order of emphasis)
Th
1. Inflammation
2. Clinical Judgment
3. Patient Education
sh
FUNDAMENTAL Reasoning: STUDENT Pediatric Asthma
History of Present Problem:
Jared Johnson is a 10 year-old African-American boy with a history of moderate persistent asthma. He is being admitted
to the pediatric unit of the hospital from the walk-in clinic with an acute asthma exacerbation. Jared started complaining
© 2016 Keith Rischer/www.KeithRN.com
This study source was downloaded by 100000809733538 from CourseHero.com on 05-14-2021 00:55:23 GMT -05:00
https://www.coursehero.com/file/74881342/STUDENT-Asthma-Fundamental-Reasoningdocx/
, of increased chest tightness and shortness of breath one day prior to admission. He has been at 50 percent of his personal
best measurement for his peak expiratory flow (PEF) meter reading which did not improve with the use of albuterol
metered dose inhaler (MDI) (per his written asthma management plan).
In the walk-in clinic Jared is alert, speaking in short sentences due to breathlessness at rest. He has coarse expiratory
wheezes throughout both lung fields with decreased breath sounds at the right base. His oxygen saturation on room air is
90%. His color is ashen and he has dark circles under his eyes. He is sitting upright and using his accessory chest muscles
to breath and has moderate intercostal and substernal retractions. He is complaining of tightness in his chest. Jared was
diagnosed with asthma at age 6 years and has three prior hospitalizations for asthma with one admission to the pediatric
intensive care unit. He has never had to be intubated with these episodes.
Personal/Social History:
He is accompanied by his mother and 16-year-old sister. Jared lives with his mother, maternal grandmother, and sister in
an older housing development in the inner city. He is in the 5 th grade and a good student despite two to three absences per
school year for his asthma. He likes to ride his bike and is the goalie on the soccer team. He says that he has lots of
friends at school and likes his teacher, Mr. Bates, who is also his soccer coach. Both Jared and his mother deny tobacco
smoke at home.
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What data from the histories are important and RELEVANT; therefore it has clinical significance to the nurse?
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RELEVANT Data from Present Problem: Clinical Significance:
eH w
History of moderate persistent asthma. Has been treated before.
o.
Increased chest tightness and shortness of Subjective data.
breath rs e
ou urc
50 percent of his personal best measurement for Oxygen is running low.
his peak expiratory flow (PEF) meter
o
Coarse expiratory wheezes throughout both Breath sounds are not normal.
aC s
lung fields with decreased breath sounds at the
vi y re
right base.
His oxygen saturation on room air is 90%. His Oxygen Saturation is low. Skin color is not normal.
color is ashen and he has dark circles under his
ed d
eyes.
ar stu
Using his accessory chest muscles to breath and Sign of a breathing problem.
has moderate intercostal and substernal
retractions.
is
Th
RELEVANT Data from Social History: Clinical Significance:
Lives with his mother, maternal grandmother,
and sister in an older housing development in
the inner city.
sh
Both patient and his mother deny tobacco Sister did not deny tobacco use.
smoke at home.
Two to three absences per school year for his Chronic problem.
asthma.
© 2016 Keith Rischer/www.KeithRN.com
This study source was downloaded by 100000809733538 from CourseHero.com on 05-14-2021 00:55:23 GMT -05:00
https://www.coursehero.com/file/74881342/STUDENT-Asthma-Fundamental-Reasoningdocx/
FUNDAMENTAL Reasoning
m
er as
co
eH w
o.
rs e
ou urc
o
aC s
vi y re
ed d
ar stu
Jared Johnson, 10 years old
Primary Concept
is
Gas Exchange
Interrelated Concepts (In order of emphasis)
Th
1. Inflammation
2. Clinical Judgment
3. Patient Education
sh
FUNDAMENTAL Reasoning: STUDENT Pediatric Asthma
History of Present Problem:
Jared Johnson is a 10 year-old African-American boy with a history of moderate persistent asthma. He is being admitted
to the pediatric unit of the hospital from the walk-in clinic with an acute asthma exacerbation. Jared started complaining
© 2016 Keith Rischer/www.KeithRN.com
This study source was downloaded by 100000809733538 from CourseHero.com on 05-14-2021 00:55:23 GMT -05:00
https://www.coursehero.com/file/74881342/STUDENT-Asthma-Fundamental-Reasoningdocx/
, of increased chest tightness and shortness of breath one day prior to admission. He has been at 50 percent of his personal
best measurement for his peak expiratory flow (PEF) meter reading which did not improve with the use of albuterol
metered dose inhaler (MDI) (per his written asthma management plan).
In the walk-in clinic Jared is alert, speaking in short sentences due to breathlessness at rest. He has coarse expiratory
wheezes throughout both lung fields with decreased breath sounds at the right base. His oxygen saturation on room air is
90%. His color is ashen and he has dark circles under his eyes. He is sitting upright and using his accessory chest muscles
to breath and has moderate intercostal and substernal retractions. He is complaining of tightness in his chest. Jared was
diagnosed with asthma at age 6 years and has three prior hospitalizations for asthma with one admission to the pediatric
intensive care unit. He has never had to be intubated with these episodes.
Personal/Social History:
He is accompanied by his mother and 16-year-old sister. Jared lives with his mother, maternal grandmother, and sister in
an older housing development in the inner city. He is in the 5 th grade and a good student despite two to three absences per
school year for his asthma. He likes to ride his bike and is the goalie on the soccer team. He says that he has lots of
friends at school and likes his teacher, Mr. Bates, who is also his soccer coach. Both Jared and his mother deny tobacco
smoke at home.
m
er as
What data from the histories are important and RELEVANT; therefore it has clinical significance to the nurse?
co
RELEVANT Data from Present Problem: Clinical Significance:
eH w
History of moderate persistent asthma. Has been treated before.
o.
Increased chest tightness and shortness of Subjective data.
breath rs e
ou urc
50 percent of his personal best measurement for Oxygen is running low.
his peak expiratory flow (PEF) meter
o
Coarse expiratory wheezes throughout both Breath sounds are not normal.
aC s
lung fields with decreased breath sounds at the
vi y re
right base.
His oxygen saturation on room air is 90%. His Oxygen Saturation is low. Skin color is not normal.
color is ashen and he has dark circles under his
ed d
eyes.
ar stu
Using his accessory chest muscles to breath and Sign of a breathing problem.
has moderate intercostal and substernal
retractions.
is
Th
RELEVANT Data from Social History: Clinical Significance:
Lives with his mother, maternal grandmother,
and sister in an older housing development in
the inner city.
sh
Both patient and his mother deny tobacco Sister did not deny tobacco use.
smoke at home.
Two to three absences per school year for his Chronic problem.
asthma.
© 2016 Keith Rischer/www.KeithRN.com
This study source was downloaded by 100000809733538 from CourseHero.com on 05-14-2021 00:55:23 GMT -05:00
https://www.coursehero.com/file/74881342/STUDENT-Asthma-Fundamental-Reasoningdocx/
