The nurse is assessing a 6 year-old male client with a history of asthma who was brought to the emergency department
The nurse is assessing a 6 year-old male client with a history of asthma who was brought to the emergency department (ED) and reports shortness of breath during a soccer game.
The nurse completes a triage assessment with the following data:
| Temperature | 99.2oF |
| Heart rate | 96 beats/min |
| Respirations | 32 breaths/min |
| Blood pressure | 97/66 mm Hg (sitting) |
| Oxygen saturation | 89% (room air) |
| Health History |
|
Indicate which assessment findings are Expected or Requires Follow-Up by the nurse.
Group of answer choices
Child reports no pain
[ Choose ] Expected Requires Follow-up
Child is restless and refuses to lie down in bed
[ Choose ] Expected Requires Follow-up
Wheezing in both lungs
[ Choose ] Expected Requires Follow-up
Minimal air movement noted in lower lobes bilaterally
[ Choose ] Expected Requires Follow-up
Child only nods head “yes” or “no” to questions
[ Choose ] Expected Requires Follow-up
Parents are at the bedside and providing comfort
[ Choose ] Expected Requires Follow-up
Peak flow meter results are <50% of child’s baseline
[ Choose ] Expected Requires Follow-up
Moderate intercostal retractions
[ Choose ] Expected Requires Follow-up
Complete Answer:
