A 6-year-old child with asthma is brought to the clinic because the parents have noticed daily wheezing for the past week, especially during the night. The PNP recognizes that this may indicate the child has:

A 6-year-old child with asthma is brought to the clinic because the parents have noticed daily wheezing for the past week, especially during the night. The PNP recognizes that this may indicate the child has:

• A. Intermittent asthma
• B. Mild persistent asthma
• C. Moderate persistent asthma
• D. Severe persistent asthma

Answer: (C)

Understanding how pediatric asthma is categorized by how often symptoms occur and how often the child wakes at night helps guide treatment. Daily daytime wheeze means this is not intermittent asthma. Nighttime symptoms indicate the asthma is not well controlled. When daytime symptoms are daily and nighttime awakenings occur more than weekly (not necessarily nightly), the pattern fits moderate persistent asthma. If symptoms were present all day with nightly awakenings and marked limitation, it would be severe persistent. So this presentation best aligns with moderate persistent asthma, guiding a step-up to daily controller therapy (often an inhaled corticosteroid) with a rescue inhaler and an action plan.

Understanding how pediatric asthma is categorized by how often symptoms occur and how often the child wakes at night helps guide treatment. Daily daytime wheeze means this is not intermittent asthma. Nighttime symptoms indicate the asthma is not well controlled. When daytime symptoms are daily and nighttime awakenings occur more than weekly (not necessarily nightly), the pattern fits moderate persistent asthma. If symptoms were present all day with nightly awakenings and marked limitation, it would be severe persistent. So this presentation best aligns with moderate persistent asthma, guiding a step-up to daily controller therapy (often an inhaled corticosteroid) with a rescue inhaler and an action plan.