Case Study # 3
UNRS 314
Asthma
Name ___________________ Number
6 year old admitted to the unit with asthma. According to the mother she noted that the child was
wheezing and having difficulty breathing. His temp is 101 and he has been complaining of an
earache. He has a history of an asthma attack one year ago. The current illness started as a cold
and cough 1 week prior to admission. He is admitted to the unit from the ER with a diagnosis of
asthma and ROM (right otitis media). You admitted him and are giving him the medications as
ordered.
Weight 47 pounds: weight in kg ________________
Calculate maintenance IV fluids _____________________
Calculate 1 ½ times maintenance for IV fluids ________________________
Physician Orders:
 IV Dextrose 5% in 0.45 Normal Saline @ 80 mL / hour
 Oxygen to keep oxygen sats at 96 to 100%
 CPT every 4 hours prn
 Xopenex via nebulizer q 2-4 hours prn for wheezing
 Methylprednisolone IV 20 mg q 6 hours
 Tagamet 80 mg IV q 6 hours
 Azithromycin 200 mg po first dose and 100 mg po x 1 daily x 4 days
How provided:
 Methylprednisolone 40 mg / mL
 Tagamet 300 mg / 2 mL
 Azithromycin suspension 200 mg / 5 mL
Methylprednisolone (Solu-medrol) 20 mg IV
Dosing: 1 to 2 mg mg / kg as loading dose and maintenance 0.5 to 1 mg/kg every 6 hours
Medication
Action:
mg/kg calculations
Nursing
Responsibilities
How fast can drug be
administered IV?
Why this drug?
mg/kg calculations
Nursing
Responsibilities
How fast can drug be
administered IV?
Why this drug?
Labs:
Classification
Tagamet 80 mg IV
Dosing per drug book: 20 – 40 mg / kg / day
Medication
Action:
Labs:
Classification
Azithromycin 60 mg po
Dosing: 10 mg / kg x 2 doses on first day and 5 mg / kg one daily x 4 days
Medication
Action:
mg/kg calculations
Nursing
Responsibilities
How fast can drug be
administered IV?
Why this drug?
Labs:
Classification
Xopenex to be administered per respiratory therapist
Classification:
Action:
Indication and uses:
Contraindications:
Side effect:
Nursing implications
Critical Thinking: The mother asks you what the IV medications are for. How would you explain
the medications to her.