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A Partnership in Treating Childhood Asthma
and that the maternal grandfather had asthma. The child is not currently on any medication and has no known allergies. The nurse continues with the assessment by asking the parent and child questions pertaining to frequency of day/night symptoms, frequency of exacerbations, and limitations regarding physical activity (Hockenberry, 2003). After interviewing the child and parent, the nurse learns that the child has had daytime symptoms during soccer practice and games, and nighttime symptoms once over the last month. Collecting subjective/objective data from the parents and child and utilizing examination results found in the child’s chart will enable the nurse to accurately prioritize one or more nursing diagnoses relevant to caring for childhood asthma.
Analysis
The nurse will use a combined approach involving parent, child, and school in developing a multi-dimensional list (physical dimension, personal dimension, and social dimension) of the child’s current/potential strengths and stressors. Evaluation of these domains will aid the nurse in forming and prioritizing appropriate nursing diagnoses.
The child’s current strengths include: Physical – developmentally in line with fine/gross motor skills; Personal – enhanced self-esteem when participating in school activities; and Social – positive peer relationships with peers at school and soccer team.
The child’s current stressors include: Physical – unable to play soccer for more than thirty minutes without feeling asthmatic symptoms; Personal – Feelings of powerlessness, anxiety, and fear associated with asthmatic episodes; and Social – being teased by her team members after being called out of the soccer game due to asthmatic symptoms.
The child’s potential strengths include: Physical – able to participate in favorite physical activities by properly using long-term control, preventative, and quick relief medications; Personal – develops a sense of achievement and competence in self-care of asthma; and Social – teachers, coaches, and parents form a partnership in helping the child maintain a sense of normalcy while actively supporting her asthma management.
The child’s potential stressors include: Physical – Unable to play soccer and other favorite physical activities; Personal – fear that school faculty, peers, and family are treating her differently because of her asthma; and Social – lose of friends and isolated by team members.
By utilizing the assessment data gathered in order to generate a list of strengths and stressors for the child, the nurse is able to begin formulating the child’s multi-dimensional nursing diagnoses.
Nursing Diagnosis
A nursing diagnosis is an individualized statement considering the client’s personal, physical, and social dimensions. It is a conclusion drawn from the data collected which serves as a means of describing a health problem open to treatment by nurses. It is with this in mind that nurse has formulated the following nursing diagnoses.
The child’s nursing diagnoses in physical dimension include: 1) Risk for suffocation related to respiratory dysfunction as evidenced by wheezing, coughing, and/or prolonged expiration; and 2) Activity intolerance related to an inability to play a full game soccer as evidenced by rapid labored breathing and fatigue.
The child’s nursing diagnosis in personal dimension includes: 1) Risk for ineffective management of therapeutic regime related to insufficient knowledge of asthma, self-monitoring of symptoms, [next page]