Education with child and parent
Brianna and her mother need to understand asthma can be caused by narrowing of the small air passages in the lungs. It will result in breathlessness. The attack will be occurred if the child is triggered by one of the followings: colds, excessive exercise, changes in weather, cigarette smoke, dust-mites, pollens and pets. The most common signs of asthma are coughing usually happens at night, during the early hours of morning, when the weather is cool and during exercise. Wheeze breathing sounds like whistles. Asthma can be well controlled with the right medications. The two types of medication used by children are Relievers and Preventers. The Relievers are most effective if they are inhaled. They relax the narrowing of the breathing tubes making it easier for air to get through. The preventers help to prevent attacks from happening. Asthma management plan is developed to prevent asthma attacks and how to manage asthma attacks when they happen. Only the oral explanations may not be enough as Brianna, in general, will not be able to understand abstract explanations. According to Piaget's theory in preoperational stage, Crisp (2009) “children learn to think with the use of symbols and images, play is the initial method of non-language use of symbols”. Play is a good method to educate child. It is used as an instrument for communication with child. During a play session Brianna may gain some understanding of what is going to happen. The nurse can use a balloon to represent the lung. The nurse can use pictures to explain those things which can cause an asthma attack. Then the nurse can narrow the neck of the balloon to explain the outcome to Brianna. Then the nurse can show the Relievers to her and explain how to use it. After that the balloon returns to normal and air can pass through. The nurse also needs to explain the Preventers to Brianna and explain how to use it. The Preventers can help to well control her asthma. The nurse can also play a game with Brianna and ask her to remember what things she should avoid. While she is skating outside, she try to avoid leaves, cigarette smoke, paint fumes and flowers. These things may cause her asthma symptoms to play up. That game can help her easy to understand what things trigger her asthma.
According to Erikson's theory, 6 to 12 years children are during Industry versus inferiority stage, they learn to work and play with their peers. If the child have a lack of achievement compared to other peers. This may create a sense of inadequacy and inferiority for children as they judge their performance. Therefore the nurse must explain to her the asthma will not result in lack of achievement in school. It is very common, about one in eight children will have wheezing sometime during childhood. However the nurse need to remind her too much exercise may affect the asthma and keep the inhaler with her.
According to Erikson’s theory, her mother is at Generativity versus stagnation stage, Crisp (2009) "she focuses on fulfilment through creative, productive activity that contributes to future generations”. The nurse should explain to her mother that asthma should cause little or no interference with schooling in the majority of children. They should be able to take part in all normal activities, including games and competitive sports. However, physical exercise can be difficult of the asthmatic, they might need to take their medication at school. There is no need for her mother to worry about Brianna.
Asthma Management Plan
The concept of an asthma management plan may be the most useful component of education in the acute setting, providing clear instruction about which medications to take at home and how to manage the next attack are important for parent and child. Every child with asthma should have their own written asthma management plan. This is a one-page information sheet with instructions about children treatment. The asthma management plan helps child manage her asthma from day to day and keep checking how well the child's asthma is controlled each day. It helps child do this by giving you a list of symptoms to look for, based on child's usual pattern of asthma symptoms. Make sure child understand her asthma action plan and know how to use it. The asthma management plan includes name, her GP, her hospital doctor and his contact phone number. It also includes the Relievers medication, the Preventer medication and Emergency prednisolone. According to Piaget's theory in preoperational stage, the child's focus on the appearance of objects is an equally rather than the weight, quantity is equal, when deforming one of the same objects in different form, then the children will justify the same object is not the same. The nurse can use colour to represent each type of medication and ask Brianna to remember them. It also states what treatment should be given when the symptoms come out. The nurse can use pictures, for example, from one girl coughing to four girls coughing to represent the levels of symptoms and also use colour to indicate which medication should be given to Brianna.
Conclusion
The nurse should explain to both Brianna and her mother that asthma is very common in Australia. Asthma can be well controlled by taking suitable Preventer medication and should cause little or no interference with schooling in the majority of children. There is no need to worry about it.
REFERENCES
Bee H, Boyd D., (2007).The Developing Child. Boston: Pearson Education Inc.
Crisp J, Taylor C., (2009) Potter and Perry's Fundamentals of Nursing3e. Chatswood: Elsevier Australia.
Shaffer D., (2002) Developmental Psychology Childhood and Adolescence. Belmont: Wadsworth / Thomson Learning
Stenbak E., (1986) Care of children in hospital. Copenhagen, Denmark : World Health Organization, Regional Office for Europe
Cameron P, Jelinek G, Everitt L, Browne G, Raftos J., (2004) Textbook of adult emergency medicine. Edinburgh : Churchill Livingstone
Silverman M, (2002) Childhood Asthma and other Wheezing Disorders. London : Arnold ; New York : Oxford University Press
Gausche-Hill M (2004) Pediatric Airway Management for the Prehospital Professional. Sudbury, Mass. : Jones and Bartlett Publishers
Moshman D., (2005) Adolescent Psychological Development. Mahwah, N.J. : L. Erlbaum
