Problem:
Pediatric Asthma Case Study RJ is a 6 yo African American brought to the ED by his parents. He was diagnosed with asthma 6 months ago. His triggers are cats and respiratory infections. He is assessed in the ED and the following data is obtained: Wgt 60 lbs, 27.27kg HR 120 bpm, RR 34, B/P 110/70, temp 102F (oral) O2 Sat 90% RJ appears frightened and will not leave his fathers lap. Crying leads to coughing. Staff make every attempt to keep RJ calm. Parents report that his baby sister had a respiratory virus last week. She is fine and with a sitter currently. He has an asthma action plan and was in the yellow zone when parent headed to the ED. He has had two puffs of albuterol in the last hour. They did not get the prednisone prescription filled. He last voided at 0800 it is now 1400. He last drank juice at 0800 also. Assessment data: Inspiratory wheezing bilateral. Crackles in bases bilaterally. Intercostal and substernal retractions, occasional nasal flaring. Lips pale pink. Mucous membranes pale pink. CRT approx. 3 sec. Extremities warm. All Pulses equal bilaterally and bounding. Apical Pulse strong and tachycardic. No extra heart