The clinic nurse makes a follow-up telephone call to a patient with asthma. The patient reports having a baseline peak flow reading of 600 L/minute and the current peak flow is 420 L/minute. Which action should the nurse take first?
a. Tell the patient to go to the hospital emergency department.
b. Instruct the patient to use the prescribed albuterol (Proventil).
c. Ask about recent exposure to any new allergens or asthma triggers.
d. Question the patient about use of the prescribed inhaled corticosteroids.
ANS: B
The patient's peak flow is 70% of normal, indicating a need for immediate use of short-acting ?2-adrenergic SABA medications. Assessing for correct use of medications or exposure to allergens also is appropriate, but would not address the current decrease in peak flow. Because the patient is currently in the yellow zone, hospitalization is not needed.
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