Paul is a 12-year-old with mild persistent asthma well controlled on Mometasone 100 mcg/act 1 puff daily. His mother is worried that starting football will cause his asthma to worsen. What should the FNP give for guidance related to asthma and exercise?
1) Vigorous exercise helps improve symptoms in children with poorly controlled asthma without usually causing exacerbations. Paul can use his albuterol before, during and after exercise. No change to his mometasone dosing would be needed as the exercise would be the known factor in the exacerbations. Follow-up is not needed.
2) Children with asthma should be excluded from vigorous exercise and most strenuous sports as they can cause a worsening of the asthma symptoms. Paul should limit himself to activities that do not increase his heartrate or respiratory rate as well as limit his caloric intake to 30 kcal/kg to make sure he does not gain too much weight.
3) Children with asthma show improved aerobic and anaerobic fitness with moderate to vigorous/physical activity. Albuterol MDI can be used prior to/during exercise if needed as well as increase to his controller medication depending on frequency of Albuterol use. Review the asthma action plan with both Paul and his mother.