← Chapter 12
Maternal-Newborn & Paediatric Nursing · Chapter 12

The Order Round

In lower airway disease the evidence is unusually clear about what does not help, and questioning an order is a nursing intervention. Run the order round on four children — keep what is supported, question what is not — then read a peak flow zone and a blood gas trajectory in a child who is still working hard.

Round on the ward

Every order below is one somebody has genuinely written. Keep the ones this child needs and question the rest — then read why.
Pick a childThen decide on each order before you check
Waiting
Choose a patient on the left.
Only bronchospasm reverses within minutes of a bronchodilator. Mucosal oedema and mucus plugging do not — which is why a child can look better on albuterol and still be deteriorating, and why systemic corticosteroid is given early in asthma and not at all in bronchiolitis.