A child with asthma comes home with severe wheezing after gym class and needs to use his metered-dose inhaler right away. What action should the NP take?

A child with asthma comes home with severe wheezing after gym class and needs to use his metered-dose inhaler right away. What action should the NP take?

• A. Recommend that the child go to the school nurse when symptoms start.
• B. Review the child's asthma action plan and possibly increase his steroid dose.
• C. Suggest asking the school to excuse the child from gym class.
• D. Write the prescription for two metered-dose inhalers with spacers.

Answer: (D)

The priority is rapid relief of acute bronchospasm with a fast-acting inhaled bronchodilator delivered through a spacer, which maximizes delivery and ease of use during an attack. Writing a prescription for two metered-dose inhalers with spacers ensures ready access to rescue therapy both at home and at school, so relief can be given immediately without delays or gaps in care. This approach prevents dependence on finding a single device at a moment of need and supports proper inhaler technique with a spacer. Other options would either delay treatment, inappropriately alter controller therapy during an acute episode, or unnecessarily limit activity without providing the necessary rescue access.

The priority is rapid relief of acute bronchospasm with a fast-acting inhaled bronchodilator delivered through a spacer, which maximizes delivery and ease of use during an attack. Writing a prescription for two metered-dose inhalers with spacers ensures ready access to rescue therapy both at home and at school, so relief can be given immediately without delays or gaps in care. This approach prevents dependence on finding a single device at a moment of need and supports proper inhaler technique with a spacer. Other options would either delay treatment, inappropriately alter controller therapy during an acute episode, or unnecessarily limit activity without providing the necessary rescue access.