Discussion: Correct inhaler technique

Discussion question: Joshua Martin is a 5-year-old boy who started kindergarten this year. Joshua’s wheezing intensifies after he lies on the floor mats in his classroom for a nap. Joshua receives albuterol (a β2-agonist) treatments four to five times a year in the emergency department for this condition and experiences temporary relief of symptoms. The school nurse’s observations of Joshua include the following: absence of fever or sore throat, persistent dry cough, wheezing, exercise intolerance, and a history of resolution of symptoms after β2-agonists treatments. After a pulmonary function test is done at his pediatrician’s office, it is determined that Joshua has moderate persistent asthma and allergic rhinitis.

Which of the school nurse’s observations are consistent with the diagnosis of asthma?
How would you explain the purposes and expected results of a pulmonary function test?
In providing education to Joshua and his mother, how would you incorporate the use of a peak flow meter and what developmentally appropriate instructions would you give?
In developing plan of care goals, the school nurse recognizes what level of activity is appropriate for children with asthma?
The school nurse recognizes that Joshua is using correct inhaler technique by observing which demonstrations? What would you use for a child unable to use a MDI correctly?