While making rounds, the charge nurse notices that a young adult client with asthma who was admitted yesterday is sitting on the side of the bed and leaning over the bedside table

While making rounds, the charge nurse notices that a young adult client with asthma who was admitted yesterday is sitting on the side of the bed and leaning over the bedside table. The client is currently receiving oxygen at 2 liters/minute via nasal cannula. The client is wheezing and is using pursed lip breathing. Which intervention should the nurse implement?

A.
Increase oxygen to 6 liters/minute.

B.
Call for an Ambu resuscitation bag.

C.
Instruct the client to lie back in bed.

D.
Administer a nebulizer treatment.

The Correct Answer and Explanation is:

The correct answer is D. Administer a nebulizer treatment.

Explanation:

In this scenario, the young adult client with asthma is exhibiting signs of respiratory distress. The client is wheezing, which indicates that their airways are constricted and obstructed, a common symptom in asthma exacerbations. The client is also using pursed-lip breathing, a technique used to help manage shortness of breath and improve airflow by keeping the airways open longer.

Here’s a breakdown of why administering a nebulizer treatment is the most appropriate intervention:

1. Wheezing and Respiratory Distress: Wheezing is typically associated with bronchoconstriction, which is a tightening of the muscles around the airways. This is common in asthma attacks. A nebulizer treatment delivers bronchodilators directly to the lungs, helping to relax and open the airways, thereby reducing wheezing and improving airflow.
2. Pursed-Lip Breathing: While pursed-lip breathing can help manage symptoms of respiratory distress, it is not a treatment for the underlying bronchoconstriction. Nebulizer treatments are designed to address this underlying issue and provide symptomatic relief.
3. Oxygen Therapy: The client is currently receiving oxygen at 2 liters/minute via nasal cannula. While oxygen is important for patients with low oxygen levels, it does not address the primary issue of bronchoconstriction. Increasing the oxygen flow rate (Option A) may not be effective if the underlying airway obstruction is not managed.
4. Ambu Resuscitation Bag: An Ambu bag (Option B) is used for emergency situations when a patient is not breathing or has inadequate breathing. The client, though in respiratory distress, is still breathing and using pursed-lip breathing, so this intervention is premature unless there is a further deterioration in the patient’s condition.
5. Instructing the Client to Lie Back (Option C): Instructing the client to lie back in bed may actually worsen their breathing difficulties. In respiratory distress, especially with asthma, sitting upright or leaning forward often helps with breathing.

Administering a nebulizer treatment will help alleviate bronchoconstriction and improve airflow, addressing the root cause of the client’s wheezing and distress. This is the most appropriate and effective intervention to manage the current exacerbation of the client’s asthma.