NURSING 2NN3 Study Guide - Winter 2018, Comprehensive Midterm Notes - Tachycardia, Oxygen, Canada
12 Oct 2018
School
Department
Course
Professor
NURSING 2NN3
MIDTERM EXAM
STUDY GUIDE
Fall 2018
Asthma Readings
Assessment of Asthma Control
• Will have their level of control determined by the nurse.
• Every child should be screened to identify those most likely to be affected by asthma.
o Have you ever been told you have (your child has) asthma?
o Have you (has your child) ever used a puffer/inhaler or any type of medication for
breathing problems?
o Have you experienced any improvement with these medications?
• If a child is identified as, or suspected of, having asthma, the level of control should be
assessed based on
o Short-acting ß2-agonist use
o Daytime symptoms
o Night-time symptoms
o Physical activity
o Absence from school/work
o Exacerbations
• For children identified as potentially having uncontrolled asthma, the level of acuity
needs to be assessed by the nurse and an appropriate medical referral provided (i.e.,
urgent care or follow-up appointment).
Medications
• Nurses will understand the pharmacology of medications used to treat asthma in children.
• All children with asthma should have their inhaler/device technique assessed by the nurse
at each visit to ensure accurate use, as well as appropriateness of device for the
developmental level of the child. Children with sub-optimal technique will be coached in
proper inhaler/device use or switched to a more appropriate delivery device/system.
• Nurses will be able to assess for potential barriers to asthma Level IV management. The
nurse will be able to offer strategies to meet families’ needs and support them in
overcoming issues leading to treatment failure.
Asthma Education
• The nurse will provide asthma education, in collaboration with the health care team, as an
essential part of care.
• Child/family knowledge of asthma should be assessed by the nurse.
• Asthma education should be provided when knowledge and skill gaps are identified.
• Tailor asthma education to the needs of the child and family by being developmentally
appropriate, sensitive to cultural beliefs and practices, and by using a variety of teaching
methods (e.g., video, pamphlets, websites, group, role playing, problem-solving).
• The nurse can use a structured framework to build both the child’s and family’s
knowledge of asthma and self-management skills by providing basic asthma education. A
partnership between the nurse, child and family is important to engage the child and
family in an interactive educational process.
Action Plans
find more resources at oneclass.com
find more resources at oneclass.com
• All children will have an individualized asthma action plan for guided self-management,
based on the evaluation of symptoms, with or without peak flow measurements,
developed in partnership with a health care professional.
• The action plan must be reviewed, revised and reinforced in partnership Level Ia with the
parent/caregiver, child and health care professional during every contact. The nurse will
coach the parent to act as an advocate for their child, ensuring that the action plan is kept
up to date.
Referral and Follow-up
• The nurse should facilitate follow-up assessments and education to achieve and maintain
control of asthma for the child diagnosed with asthma. The nurse will determine the
child’s primary care asthma management provider by asking “who do you see for your
asthma management?”
• Nurses should advocate for a referral to an asthma specialist (respirologist, allergist,
paediatrician, Certified Asthma Educator, etc.) for the following: frequent visits to the
emergency department; poor understanding of asthma self-management; symptoms are
not responding to usual treatment; and/or uncertainty of diagnosis.
• Nurses should advocate for referral to an asthma education program and/or link to
community resources, if available.
Education Recommendations
• Nurses working with children with asthma must have the recommendations appropriate
knowledge and skills to:
o Identify the level of asthma control
o Provide basic developmentally appropriate asthma education; and identify the need
for follow-up with primary care provider and/or community resources.
Assessment of Asthma Control
• Control airway inflammation
o Symptom control during day, night and with exercise.
o Prevent exacerbations.
o Best pulmonary function.
o Least medication required with fewest side effects.
Recommendations
• Every child should be screened to identify those most likely to be affected by asthma.
o Does the child use a puffer for breathing problems? Any improvement? Told
child has asthma?
• Level of control based on:
o Short acting B2 agonist use.
o Daytime and night-time symptoms.
o Physical activity.
o Absence from school/work.
o Exacerbations.
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Children with sub-optimal technique will be coached in proper inhaler/device use or switched to a more appropriate delivery device/system: nurses will be able to assess for potential barriers to asthma level iv management. The nurse will be able to offer strategies to meet families" needs and support them in overcoming issues leading to treatment failure. A partnership between the nurse, child and family is important to engage the child and family in an interactive educational process. The nurse will coach the parent to act as an advocate for their child, ensuring that the action plan is kept up to date. Referral and follow-up: the nurse should facilitate follow-up assessments and education to achieve and maintain control of asthma for the child diagnosed with asthma. Assessment of asthma control: control airway inflammation, symptom control during day, night and with exercise, prevent exacerbations, best pulmonary function, least medication required with fewest side effects.
