NUR 471 Family Nurse Practitioner I
Case study: Asthma management
5-year-old boy presents with mother for wheezing, sore throat and cough.
1-year history of asthma, usually well controlled with budesonide nebulizer 2 times/day and albuterol inhaler 1-2
times/week for wheezing. 3 days ago, sore throat, clear nasal discharge, and a dry cough. Past 24 hours, intermittent
wheezing, used albuterol 2 puffs with a spacer every 3 hours, partial relief.
Past Medical History
Born at term without complications, no delays in growth or development.
Mother, age 28, alive & well; Father, age 30, asthma; Sister, age 3, alive & well
Lives at home with mother, father, and sister. Pre-school 5 days/week. Mother and father work full-time. Uses seat belts
in car, helmet with bike.
1. What is his asthma severity classification? _____________________ and briefly explain why?
2. What other history would you seek?
3. What is the next most appropriate action? _____________________ and briefly explain why?
4. If his respiratory rate is 50% of upper limits of normal for age. What medication would you prescribe?
____________________ and briefly explain why?
5. Does he need antibiotic therapy? (Identify the reasons for your answer)