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Discussion

doubting myself...

I have an elementary age student with history of asthma complaining of "throat" pain (he points to the center of his neck) when he breathes in. I gave him his albuterol, vital signs look good, lungs sound good, and there are no other symptoms. He states his throat still hurts. Mom was notified but didn't think he needed to go home. 

I have never had an asthmatic with only that symptom. He doesn't appear to be in any sort of respiratory distress... but should I have been more insistent in sending him home? Neck pain always frightens me, but it doesn't seem urgent, just the fact he is an asthmatic. I also asked him if he thinks he needs to go to the hospital in my attempt to gauge the true severity of the situation and he said no. 

This is still my first year school nursing, so I just want to be extra careful with everything. 

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    I would look at his Asthma Action Plan or any orders from the doctor.  If he took albuterol, had stable vital signs, and was in the "green" zone (doing well) then I would keep him at school.

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    Did he have an asthmatic cough as well? That could sure account for throat pain...

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    Can also have post nasal drip, strep, Covid, pharyngitis....what  a whacko year this has been

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    I have asthma and sometimes it manifests itself as an uncomfortable lump in the throat feeling.  Not pain per se but just an uncomfortable sensation.  Sometimes there is wheezing but not always.  If all other signs were good I think you did just fine.    

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    • Author
    16 minutes ago, Jedrnurse said:

    Did he have an asthmatic cough as well? That could sure account for throat pain...

    No cough, but mom did say she gave him robitussin yesterday... so that is definitely possible! 

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    You don't want to be "that nurse." The nurse who wanders away from handing over the inhaler because the symptom is unclear. My general practice is that I assess (PSO2, RR, auscultation for a good long time) and if I don't hear the wheezing and the RR is good and there's no SOB or positioning for comfort or blue lips....sometimes I'll ask the kid to have a cup of cold water, wait 10 and see if they're better. But I never don't give the inhaler. I just document why I was thinking it wasn't necessary.

    Don't second guess yourself. You're good at this.

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