Thursday, November 3, 2016

7:03 PM

Meet with Child & parent

Assessment of asthma symptoms
Focused lung assessment
RR rate, O2 sat*
Data collection about child & family

Assessment of home environment

Cigarette Smokers?
Pets?
Carpets? Rugs? Curtains?
Moulds?

BASIC INFORMATION ABOUT ASTHMA

Asthma is a condition that affects your child's
lungs. The most common signs of problems with
asthma include:
feeling short of breath
tightness in the chest
coughing
Wheezing

If your child has asthma, your child's airways

(breathing passages) are extra sensitive or
"twitchy." When your child is surrounded by
certain conditions or triggers, your child's
airways become narrower. This makes it hard to
breathe.

ALLERGEN CONTROL

MEDICATIONS

Pet Dander
o Remove pets in the house
o Clean house thoroughly after pet removed (furniture, carpets, stuff
toys & heating + cooling system)

Dust mites
o Allergic to the dropping of dust mites. They live in warm, moist
placed w/ lots of shed human skin (mattress, pillows, bedding,
carpets, rugs & upholstered furniture)
o Wash linens in very hot water every week
o Cover childs mattress, spring, pillow w/ allergen proof that
enclose the mattress
o Remove carpets, rugs, heavy curtain in childs bedrooms
(preferably the rest of the house)
o Remove stuffed animals + dolls
o Vacuum the carpet & dust every week
o Keep humidity level below 30% (use dehumidifier in damp areas.
Dust mites do not survive in dry environments)
Moulds

o Occur in damp, such as basements & bathroom. They can travel

in the air to anywhere in the home
o Soap + detergent + water to clean small areas. May need
substance that is specifically for killing mould ( fungicide)
o Ventilate home well
Foods
o Food allergies do not cause asthma, but can develop it.
o Common: milk, eggs, peanut, nuts, wheats, soy, shellfish & fish

EMERGENCY INTERVENTIONS

Cough that does not go away

Coughing at night
worsens
Coughing until vomiting
Difficulty catching breath
Tired gets soon after playing or exercising
Seeming grumpy, cranky
Signs of cold (sneezing)
Reports chest pain, tiredness, difficulty breathing, wheezing in chest

HOW TO USE MEDICATIONS:

Metered Dose Inhaler

1. Shake the inhaler well before use (3 or 4 shakes)

2. Breathe out, away from your inhaler
3. Bring the inhaler to your mouth. Place it in your mouth between your teeth
and close your mouth around it.
4. Start to breathe in slowly. Press the top of you inhaler once and keep
breathing in slowly until you have taken a full breath.
5. Remove the inhaler from your mouth, and hold your breath for about 10
seconds, then breathe out

Metered Dose Inhaler w/ a spacer

1) Shake the inhaler well before use (3-4 shakes)
2) Breathe out, away from the spacer
3) Bring the spacer to your mouth, put the mouthpiece between your teeth and
close your lips around it
4) Press the top of your inhaler once
5) Breathe in very slowly until you have taken a full breath. If you hear a whistle
sound, you are breathing in too fast. Slowly breath in.
6) Hold your breath for about ten seconds, then breath out.

Worsening Asthma Symptoms include:

Ensure to educate on CONTROLLER medications to be taken daily,

regardless of symptoms.
RELIEVER meds to be taken when asthma symptoms worsen

DISKUS (Dry Power Inhaler)

Difficulty talking
Trouble waking up, unusually sleepy
Lips/skin blue
Skin sucking in (indrawing) on neck or chest as child
breathes
To do:

CALL 911

1) Open your DISKUS: Hold it in the palm of your hand, put the thumb of your
other hand on the thumb grip and push the thumb grip until it "clicks" into
place
2) Slide the lever away from you as far as it will go to get your medication ready
3) Breathe out away from the device
4) Place the mouthpiece gently in your mouth and close your lips around it
5) Breathe in deeply until you have taken a full breath
6) Remove the DISKUS from your mouth
7) Hold your breath for about ten seconds, then breathe out
8) Always check the number in the dose counter window to see how many
doses are left.

Give reliever medication until ambulance comes in.

To do:

*Follow asthma action plan (provide info on reliever medication)

o Family teaching on how to give reliever medication

RETURNING TO SCHOOL

EXERCISING

Communicate to childs teacher & school about asthma.

o Know how to help with reliever medication for an asthma episode
Medication to include:
o Name of child, medicine, # of doses, Dr.s phone number
Store the medication in a cool, dry place where other students cannot get them
Give teacher a list of childs asthma trigger and explain why it is important for child to avoid them in
school.
o Tell them to avoid dust and let child sit away from blackboard. Your child should not clean
blackboard erasers
o Avoid pets & plants in the classrooms
o Avoid carpet & mats (bring own mat or ask to separate child form other childrens mats
o If weather is very cold or dry, then let childs teacher know they may need to stay indoors.
May miss school d/t episodes or medical appointments. Communicate this with teacher and child will be
accommodated in missing school work.

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Make sure child warms up before & cools off AFTER exercise
Take reliever medication 15-20 minutes before exercising.
When exercising, take breaks & exercise for short period of time
o Wheezing + coughing stop exercising, follow asthma plan
DO NOT exercise when:
o Hot/humid outside
o Air pollution or pollen index high
o After asthma episode (give child time to return to normal)

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