A mother is struggling to manage her child's moderate persistent asthma at home. The mother asks the nurse if there are any nonpharmacologic measures she can use. Which strategies are most likely to be effective?
1. Keeping the child's immunizations up-to-date and wearing a face mask in public
2. Limiting intake of protein and foods with red and yellow dyes
3. Avoiding stimuli such as secondhand smoke, pollutants, and cold air
4. Homeschooling the child and limiting his contact with other children who might have upper respiratory infections
Correct Answer: 3
Rationale 1: Immunizations are important but are not helpful in the management of asthma. A face mask in public is not an effective strategy, and the child may be ostracized.
Rationale 2: Protein limitation is not indicated. Some individuals are sensitive to dyes and should be treated by an allergist.
Rationale 3: Environmental controls call for limiting a child's contact with potential allergens, particularly at night, when the airway is most reactive. Stimuli such as secondhand smoke, pollutants, and cold air can trigger hyperresponsiveness in clients with asthma.
Rationale 4: Homeschooling might actually exacerbate the child's problem and worsen social isolation.
Global Rationale: Teach the patient to supplement drug therapy with nonpharmacologic measures including: increased fluid intake to liquefy and assist in mobilizing mucus; small, frequent meals of calorie-rich, nutrient-dense foods to prevent fatigue and maintain normal nutrition; adequate rest periods between eating and activities; decreased room temperature for ease of breathing during sleep; and reduced exposure to allergens where possible. The patient should also avoid environments with secondhand smoke. Immunizations are important but are not helpful in the management of asthma. A face mask in public is not an effective strategy, and the child may be ostracized. Protein limitation is not indicated. Some individuals are sensitive to dyes and should be treated by an allergist. There is no guarantee that homeschooling will be an effective environmental control and may result in social isolation.
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