childhood asthma, a reversible obstructive lung disease. It is a chronic inflammatory disorder of the airways caused by increased airway reaction to various stimuli. Most children who have asthma develop symptoms before 5 years of age. Asthma in young children (less than 5 years old) is hard to diagnose. It can be a life-threatening disease if not properly managed. It is the third leading cause of hospitalization among children under the age of 15 and a leading cause of school absenteeism. ▪ OBSERVATIONS: The symptoms of asthma vary widely in frequency, duration, and degree of symptoms. They may range from frequent coughing spells (which may occur during play, at night, or while laughing or crying), occasional periods of wheezing, and slight dyspnea to severe attacks that can lead to total airway obstruction (resulting in status asthmaticus) and respiratory failure. The child with acute asthma has shortness of breath, chest congestion or tightness; chest pain (particularly in younger children); inability to talk, eat, or play; vomiting; or excessive use of stomach muscles to breathe ▪ INTERVENTIONS: Management of asthma in children is based on symptoms and prevention of attacks. In the long-term management of asthma in children, an effort is made to control the symptoms with the minimum amount of medication, increasing the number and frequency of medications as symptoms increase and reducing the level as symptoms are brought under control. A written asthma action plan is an important tool to let patients and their caregivers know how well treatment is working. The plan outlines the steps needed to manage the child’s asthma. ▪ PATIENT CARE CONSIDERATIONS: Prognosis varies considerably; asthma symptoms that start in childhood can disappear for some teens and young adults. For others, symptoms go away only to return a few years later. But some children with asthma, particularly those with severe asthma, never outgrow it. The primary focus of care for children with asthma is to relieve symptoms of respiratory distress. The health care team implements measures to promote physical comfort, induce rest, and reduce fatigue and anxiety. An especially important role is to reassure the child and parents about procedures, equipment, and prognosis. Each member of the health care team plays a significant role in the long-term support of children with chronic asthma, primarily in teaching the child and parents about the disease, about how to avoid triggers, and how to cope with the condition.
