During an asthma action plan visit, the child is extremely anxious. What should the clinician do first?

During an asthma action plan visit, the child is extremely anxious. What should the clinician do first?

• A. Ask the child's parent why the child is so anxious.
• B. Review the purpose of this visit and any anticipated procedures.
• C. Reassure the child that there is nothing to be afraid of.
• D. Perform a physical assessment to rule out shortness of breath.

Answer: (B)

When a child is extremely anxious in a clinic setting, the first priority is to orient them to what will happen and why they’re there. Reviewing the purpose of the asthma action plan visit and outlining the anticipated procedures helps the child and family understand what to expect, reduces uncertainty, and builds a sense of safety and cooperation. This sets a calm foundation so the clinician can progress with the visit—addressing inhaler technique, action steps, and any needed assessments—without the barrier of fear. Starting by explaining the visit avoids making assumptions about the child’s fear and prevents dismissing their feelings. It also helps the parent participate supportively and reinforces trust. Asking why the child is anxious or jumping straight to a physical exam before the child understands what will happen can increase discomfort, and simply reassuring the child that there’s nothing to fear may feel insincere and fail to address the real concerns behind the anxiety. If there were true breathing concerns, a careful assessment would come after the child has been reassured and oriented, not before.

When a child is extremely anxious in a clinic setting, the first priority is to orient them to what will happen and why they’re there. Reviewing the purpose of the asthma action plan visit and outlining the anticipated procedures helps the child and family understand what to expect, reduces uncertainty, and builds a sense of safety and cooperation. This sets a calm foundation so the clinician can progress with the visit—addressing inhaler technique, action steps, and any needed assessments—without the barrier of fear.

Starting by explaining the visit avoids making assumptions about the child’s fear and prevents dismissing their feelings. It also helps the parent participate supportively and reinforces trust.

Asking why the child is anxious or jumping straight to a physical exam before the child understands what will happen can increase discomfort, and simply reassuring the child that there’s nothing to fear may feel insincere and fail to address the real concerns behind the anxiety. If there were true breathing concerns, a careful assessment would come after the child has been reassured and oriented, not before.