Hannah McGregor a 9-year-old with asthma

Hannah McGregor, a 9-year-old with asthma, lives at home with her parents and two brothers, who are 6 and 4 years old. Hannah developed asthma at approximately 5 years of age and has had wheezing episodes that were generally controlled by rescue medications. Two weeks ago, Hannah had a severe asthma episode that started at school and was possibly associated with the paint or glue used on a project. She did not have any quick-relief medications at school, and she delayed going to the school nurse so that she could finish her project. By the time her mother arrived to pick her up, Hannah was in respiratory distress. After receiving treatment in the emergency department (ED), Hannah was admitted to the pediatric intensive care unit.

Hannah and her mother are in the health center to meet with the provider to learn more about asthma management. At today’s visit, Hannah’s lungs are clear to auscultation, and her peak expiratory flow reading is in the green zone. Mrs. McGregor reports that she has given all prescribed medications since the hospitalization. Both Hannah and her mother are motivated to prevent a future hospital admission if possible. The nurse uses a model to show Hannah how asthma narrows her airway and makes it difficult to breathe. The nurse then works with Mrs. McGregor and Hannah to develop a plan for asthma control with daily medications.

Question 1
What is the pathophysiology of asthma?

Question 2
What are the current recommendations for managing Hannah’s asthma and to help prevent asthma episodes?

Question 3
How should Hannah handle future episodes that start at school?

Question 4
What arrangements are needed for Hannah to have access to her medications at school?

Question 5
What are common triggers for asthma?