Page 1029 - Saunders Comprehensive Review For NCLEX-RN

of the risk for febrile seizures.
k. Institute isolation precautions with
pneumococcal or staphylococcal
pneumonia (according to agency
policy).
l. Administer cough suppressant if
prescribed before rest times and meals
if the cough is disturbing
(administered with caution because
they can interfere with the clearance of
respiratory secretions).
m. Continuous closed chest drainage may
be necessary if purulent fluid is
present (usually noted in
Staphylococcus infections).
n. Fluid accumulation in the pleural cavity
may be removed by thoracentesis;
thoracentesis also provides a means for
obtaining fluid for culture and for
instilling antibiotics directly into the
pleural cavity.

Children with a respiratory disorder should

be monitored for weight loss and for signs of
dehydration. Signs of dehydration include a sunken
fontanel (infants), nonelastic skin turgor, decreased
and concentrated urinary output, dry mucous
membranes, and decreased tear production.
VI. Asthma
A. Description
1. Asthma is a chronic inflammatory disease of the
airways (see Chapter 50).
2. Asthma is classified on the basis of disease severity;
management includes medications, environmental
control of allergens, and child and family education.
3. The allergic reaction in the airways caused by the
precipitant can result in an immediate reaction with
obstruction occurring, and it can result in a late
bronchial obstructive reaction several hours after the
initial exposure to the precipitant.
4. Mast cell release of histamine leads to a
bronchoconstrictive process, bronchospasm, and
obstruction.
5. Diagnosis is made on the basis of the child’s
symptoms, history and physical examination, chest
radiograph, and laboratory tests (Box 35-3). See Table
35-2 for a classification system for asthma severity.

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