Which breathing exercise should the nurse have an asthmatic 3-year-old do to increase her expiratory phase?

• A. Blow a pinwheel.
• B. Use an incentive spirometer.
• C. Breathe into a paper bag.
• D. Take several deep breaths.

Answer: (A)

Prolonging expiration helps in asthma because narrowed airways tend to trap air during the long, slow part of breathing. Teaching a child to exhale slowly and steadily reduces airway collapse and work of breathing, improving gas exchange.

Blowing a pinwheel gives a simple, fun way to practice that longer exhale. The pinwheel moves only if the child exhales with control and enough duration, providing immediate visual feedback and reinforcing a slower, more extended expiratory phase. This directly targets the expiratory prolongation that helps with asthma symptoms.

Incentive spirometry is focused on deep inhalation and is harder for a 3-year-old to use reliably. Breathing into a paper bag isn’t appropriate for asthma and can be unsafe, and taking several deep breaths can encourage quicker, not slower, breathing.