A 9-year-old boy with a history of mild persistent asthma presents to the emergency department with a 24-hour history of worsening cough, shortness of breath, and chest tightness. He recently had symptoms of a mild viral upper respiratory tract infection. Vital signs show a temperature of (), heart rate of , respiratory rate of , and oxygen saturation of on room air. Physical examination reveals mild intercostal retractions and diffuse expiratory wheezing bilaterally. Which of the following are appropriate initial steps in the management of this patient's condition? (Select all that apply)
- Administration of nebulized albuterolCevap
- Administration of oral prednisoneCevap
- CPrescription of oral amoxicillin-clavulanate
- DAdministration of nebulized hypertonic saline
- EAdministration of intravenous furosemide
Cevap
The correct initial steps are the administration of nebulized albuterol and the administration of oral prednisone.
The correct options involve standard, evidence-based initial therapy for an acute asthma exacerbation. Nebulized albuterol provides rapid bronchodilation via smooth muscle relaxation, and oral prednisone acts systemically to decrease acute airway inflammation, which is the underlying pathophysiological mechanism of the exacerbation.
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Anahtar Kavram
The initial management of acute asthma exacerbations in children requires rapid reversal of bronchospasm with short-acting beta-agonists and reduction of airway inflammation with systemic corticosteroids.