9 year old Alan comes in with complaints of "chest tightness". His breathing is mildly labored and he is audibly wheezing. His peak flow is 50% of his normal range. Significant findings include moderate inspiratory and expiratory wheezing with moderate air exchange. His O2 is 96% by pulse oximetry. His mother reports that his asthma has been under control but in the past month, he has needed his rescue inhaler almost daily. In addition, he has awakened frequently at night with coughing. His current meds include Advair 100mcg, which he used twice daily. He uses Albuterol for wheezing.

This learning activity was developed by Christine Pintz, FNP, MSN, coordinator of the Family Nurse Practitioner program at the George Washington University, in collaboration with Partnerships for Training, an Association of Academic Health Centers program funded by the Robert Wood Johnson Foundation.