A night shift nurse is caring for a pediatric client admitted earlier in the day following a severe asthma attack. To promote comfort at the time the client is going to bed for the night, the nurse instructs the client to assume which position?
A night shift nurse is caring for a pediatric client admitted earlier in the day following a severe asthma attack. To promote comfort at the time the client is going to bed for the night, the nurse instructs the client to assume which position?
A. High or semi-Fowler's position
[86%]
B. Prone position
[3%]
C. Side-lying position
[9%]
D. Supine position
[2%]
Statistics
Subject/Lesson
Subject
Child Health
Lesson
Respiratory
Client Need
Test Plan
Basic Care and Comfort
Related Topic
Non-Pharmacological Comfort Interventions
Item Type
Item Type
Application
Explanation
Choice A is correct. Although this pediatric client initially presented with a severe asthma attack which has since resolved, this night shift nurse is correct in providing instruction regarding nocturnal sleep positioning, as nocturnal asthma exacerbation is a concern for this pediatric client. Nocturnal asthma symptoms are common and more pronounced in clients with more severe forms of asthma. This client, having required hospitalization due to a severe asthma attack, should be considered to have a more severe form of asthma. Here, the nurse should instruct the client to sleep in a high or semi-Fowler's position, as these two positions have been shown to be the most effective in preventing nocturnal asthma exacerbations.
Choice B is incorrect. Sleeping in a prone position has been shown to increase the likelihood of a nocturnal asthma exacerbation.
Choice C is incorrect. Sleeping in a side-lying position has been shown to increase pulmonary constriction and, subsequently, the likelihood of nocturnal asthma exacerbations.
Choice D is incorrect. Sleeping in a supine position has been shown to increase the likelihood of nocturnal asthma exacerbations, primarily due to the worsening of several known contributing factors (i.e., gastroesophageal reflux disease and/or obstructive sleep apnea) and should therefore be avoided.
Learning Objective
When caring for a pediatric client following an asthma attack, recognize the need to instruct the client to sleep in a high or semi-Fowler's position to reduce the risk of a nocturnal asthma exacerbation.
Related Videos
4 Key Topics
Asthma
17.6 Airway Disorders
Bronchodilators
6.5 Respiratory System Drugs
Additional Info
✓ In those with asthma, clients with more severe disease are significantly more likely to experience nocturnal asthma.
✓ The chances of experiencing asthma symptoms or an exacerbation are higher during sleep.
✓ Posture is an important determinant of pulmonary mechanics, which has critical implications for clients with asthma.
✓ Although the exact causation of nocturnal asthma has yet to be identified, certain contributing factors have been identified.
✓ Many of these contributing factors are exacerbated by the choice of one's sleeping position, including, but not limited to:
- Gastroesophageal reflux disease (GERD)
- Obstructive sleep apnea (OSA)
- Sinusitis (more specifically, postnasal drip)
