Asthma questions- confused, please help!! :)

[wyshywashy]

If a patient comes into the ED with possible signs of an asthma attack as evidenced by respiratory distress, retractions, use of accessory muscles, dyspnea, and signs of cyanosis:

Is this the recommended sequence of actions :

1) nurse should do a quick assessment to obtain vitals and lung sounds

2) then administer short-acting beta agonists bronchodilator via metered dose inhaler and oral steroids

3) then administer oxygen via nasal cannula 1-2 L/min

4) then inform MD even if exacerbation has resolved after the above course of action.

i put o2 last because I figured the o2 would not work without bronchodilaton first.

Is this the correct sequence for adults and children?

Can MDI be used with spacers chambers to administer short-acting rescue bronchodilators or is it just for long-acting bronchodilators and steroids?

Is that the preferred device for rescue emergencies in adults and children?

Thank you for any clarity you can provide. I am a newer nursing student, preparing for an upcoming exam.

[Double-Helix, BSN, RN]

It sounds like you've got a good understanding of the material. In real life in the ER, your short-acting beta agonist (albuterol) is probably going to be administered via a nebulizer, concurrently with oxygen. But if MDI is your only option, then yes, you would give that prior to giving oxygen.

A spacer simply disperses the aerosolized medication into a contained air space to allow it to be more adequately inhaled into the lungs. First dispersing the medication dose into a spacer cuts down on the amount of medication that may become attached to the oral mucosa during inhalation. What kind of medication being dispersed (long or short acting) is not relevant.

[wyshywashy]

Thank you so much! :)