I have a student who has an inhaler in the clinic for PRN use.
She comes to me at least every day stating that she is "wheezy".
I get my stethoscope and check for wheezes, crackles, anything out of the norm.
This kid sounds clear as a bell. No SOB, no wheezing, no cough, nothing.
So I do not administer the inhaler. Mom get's mad at me for withholding the medication. But the kid is not having any asthma !
Can you all help me out here. What do you do in cases like this ? Do you give the med either way, in order to please the parent, or do you not give it, because there is no indication of asthma noted ?
If this is a child I am not familiar with, I will evaluate using peak flow meter as well as pulse ox and auscultation. I assume the child does not have an action plan.
Anytime you need a relief inhaler more than 2 times a week (except for EIA) then the doctor needs to be seen. The child's control medication needs to be reevaluated.
okschoolnurse
38 Posts
If this is a child I am not familiar with, I will evaluate using peak flow meter as well as pulse ox and auscultation. I assume the child does not have an action plan.
Anytime you need a relief inhaler more than 2 times a week (except for EIA) then the doctor needs to be seen. The child's control medication needs to be reevaluated.
check out http://www.freebreather.com for usable tools for evaluation, documentation and planning.