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Workplace Personality Assessments

Pediatric Asthma Exacerbation Management

Pediatric Asthma Exacerbation Management

Describe your clinical experience for this week.

  • Did you face any challenges, any success? If so, what were they?
  • Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.
  • Mention the health promotion intervention for this patient.
  • What did you learn from this week’s clinical experience that can beneficial for you as an advanced practice nurse?
  • Support your plan of care with the current peer-reviewed research guideline.

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.

Pediatric Asthma Exacerbation Management

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APA

Pediatric Asthma Exacerbation Management

This week’s clinical experience provided me with valuable hands-on exposure to pediatric acute care, particularly in managing a child with an acute asthma exacerbation. The case challenged my critical thinking, assessment skills, and ability to provide effective patient education, reinforcing the importance of evidence-based practice in advanced nursing care.

Challenges and Successes
Challenges Faced

  1. Assessing a Pediatric Patient in Respiratory Distress:

    • The 5-year-old patient was scared and non-verbal due to difficulty breathing, making history-taking and physical examination challenging.
    • The patient’s mother was extremely anxious, which made communication more difficult.

  2. Medication Adherence Concern:

    • The patient had multiple recent ER visits for asthma attacks, suggesting poor controller medication adherence at home.
    • The mother expressed reluctance to give daily inhaled corticosteroids (ICS) due to fear of “steroid side effects.”

Successes

  1. Effective Crisis Intervention:
    • I quickly identified respiratory distress signs and initiated the correct acute treatment protocol, leading to rapid symptom improvement.
  2. Parental Education:
    • After addressing concerns about steroid use and explaining how controller medications prevent exacerbations, the mother was more receptive to long-term asthma control strategies.

Patient Assessment

Chief Complaint:

  • The 5-year-old boy presented with wheezing, shortness of breath, and chest tightness for the past 24 hours, worsening overnight.

Signs and Symptoms (S&S)

  • Respiratory distress:
    • Tachypnea (RR: 40 breaths per minute)
    • Accessory muscle use (suprasternal retractions)
    • Oxygen saturation: 91% on room air
    • Audible wheezing
  • Cough and chest tightness
  • Recent URI symptoms (suggesting a viral trigger)

Assessment Findings

  • Auscultation: Diffuse expiratory wheezing, prolonged expiratory phase.
  • Peak Expiratory Flow Rate (PEFR): 55% of predicted, indicating moderate-severe exacerbation.
  • No signs of pneumonia or foreign body aspiration on