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Chloe is a 7-year-old who weighs 50 pounds.  She has had eczema since she was 8 months old. Her mot

Chloe is a 7-year-old who weighs 50 pounds.  She has had eczema since she was 8 months old. Her mot. Question
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Asked by odinakag

Chloe is a 7-year-old who weighs 50 pounds.  She has had eczema since she was 8 months old. Her mother has triamcinolone at home and she begins a course of treatment every time Chloe gets an eczema outbreak. She uses one half-fingertip of ointment and rubs it slowly into her skin spreading it over the rashes as much as she can.  She does this twice a day.  Over the past year, the steroid cream has not been working very well. 

 

When Chloe was four she had her first asthma attack.  She does nebulizer treatments with albuterol at home when she feels wheezy.  She typically has 1-2 attacks per year except in Fall when she has allergies.  Then she feels wheezy most days.  She has never been hospitalized for asthma, but she has missed several days of school.

 

She is in the emergency room today for an acute exacerbation of asthma that scared mom.  Before she came in her mother gave her two nebulizer treatments of albuterol.  Chloe has had 4 asthma attacks over the past week – all at school, and she has had one nighttime awakening this week. 

 

Why do you think the triamcinolone is no longer completely effective for Chloe’s eczema? Give 3 possible reasons. (1 point)
What are two things (non-pharmacologic) that you can teach mom to do to improve the penetration of the triamcinolone into Chloe’s skin?
Chloe needs a “step-up” in care.
What stage is she in now?
How would you classify her asthma when she had 1 or 2 attacks per year?
When will Chloe be able to “step down” her care?
What medication will be ordered? ____________. Is this a SABA, LABA, ICS, or LAMA?
The new medication comes in an inhaler.
How will you educate Chloe and her mom to use an inhaler at home?
During your practice with her, you notice that Chloe is having some trouble coordinating her breaths with the inhaler. You notify the prescriber that you need something.  What do you need?
Mom asks if it is okay to send Chloe to school even though she may have an attack. What can be done to minimize school days lost? 
To reduce the number of attacks and school days lost during this allergy season an antihistamine was ordered.
First-generation antihistamines are very effective, but what common side effects make them a poor choice for Chloe?
When would a first-generation antihistamine be a good choice, despite the side effects for Chloe?
Second-generation antihistamines can be used prophylactically (daily) with few side effects. Name a medication in this category.
Name two things you would discuss with Chloe and mom to prevent asthma attacks during flu and cold season?
Chloe is going home with an order for prednisone elixir 1.2 mg/kg/day in three divided doses. You are to give the first dose in the ER before she goes home.  You receive the bottle which says prednisone 15mg/5cc. The pharmacist’s label says to give 3cc three times per day.  While you give it you will show mom how much it should look like in the special dropper.
Show the calculations needed to make this dose decision (4 points). Is the pharmacist’s calculations correct?
SCIENCE
HEALTH SCIENCE
NURSING
UNRS 445

Chloe is a 7-year-old who weighs 50 pounds.  She has had eczema since she was 8 months old. Her mot

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