Discuss two high priority nursing strategies used to manage a child with a severe acute exacerbation of asthma and provide rationales for these strategies.

You are to develop a concept map for the topic severe acute exacerbation of childhood asthma
and answer three questions related to a severe acute exacerbation of asthma.
Question 1.
In a severe acute exacerbation of asthma explain the pathogenesis that results in widespread
expiratory wheezes and dyspnoea.
Question 2.
Discuss two high priority nursing strategies used to manage a child with a severe acute exacerbation
of asthma and provide rationales for these strategies.
Question 3.
To manage a severe acute exacerbation of asthma in a child continuous nebulised salbutamol is
given. Three doses of ipratropium is added to the nebuliser at 20 minute intervals.
a) Discuss the mode of action of each of these drugs (salbutamol and ipratropium) relating to the
underlying pathogenesis.
b) Relating your answer to the pharmacology of the two drugs, discuss nursing implications
including how you will monitor and respond to adverse effects and how you will evaluate the
therapeutic effect.