Home Care for the Child with Asthma
IDENTIFY CURRENT KNOWLEDGE ABOUT THE CONDITION AND ITS IMPACT ON
a. Review the parents’ and older child’s understanding of asthma pathophysiology and its effect
on the child. Ask:
■What causes asthma? What happens in the lungs during an acute asthma episode?
■What are the early warning signs of an acute asthma episode in your child?
■What are your child’s symptoms and how does he or she respond to them? Does your child
wake up at night? Does your child cough a lot? When?
■Is your child involved in any exercise activity? If no, why not? Do asthma symptoms
■Does asthma interfere with social activities or activities with friends?b.What are the child’s
personal asthma triggers? (Suggest that the parents and child keep a written log of symptoms that
occur during the day and night, as well as when and where symptoms occur to help identify
triggers, e.g., home, school, outdoors, with exercise.)
SET UP A SCHEDULE FOR PARENTS TO LEARN ASTHMA MANAGEMENT
■Make sure the parents understand that asthma is a chronic condition that needs daily
management and environmental control to reduce or prevent acute asthma episodes.
■Work with the physician to develop an asthma action plan for daily management, quick relief,
and when to call the physician or seek emergency care.
■Assess the child’s technique when using a peak expiratory flow meter (PEFM), and
correct technique as needed. Discuss when to use the PEFM and how to interpret and use the
results for asthma control. Keep a record of PEFM readings for 2 weeks prior to each health
REVIEW PARENTS’ UNDERSTANDING OF MEDICATION THERAPY
■Provide information about medications: name, type of drug, dose, method of
administration, expected effect, and possible side effects. Make sure families understand that
daily control medication helps pre-vent acute asthma episodes, so the child will not feel them
working as he or she does with quick-relief medications. Address the parents’ fears about maintaining their child on “steroid” medication, and make sure they understand this is
different from the anabolic steroids used and abused by athletes.
■Assess the child’s technique for the use of an MDI or DPI and correct as needed.
■When parents use a nebulizer treatment for an infant or young child, suggest diversions
that might help the child cooperate during the 8- to 10-minute treatment.