Asthma
Order Instructions:
Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening symptoms. Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors. One method that supports the clinical decision-making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.
To prepare:
•Consider drugs used to treat asthmatic patients including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients including adults and children.
•Review Chapter 25 of the Arcangelo and Peterson text. Reflect on using the stepwise approach to asthma treatment and management.
•Consider how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.
To complete:
Write a 2- to 3- page paper that addresses the following:
•Describe long-term control and quick relief treatment options for asthma patients, as well as the impact these drugs might have on patients.
•Explain the stepwise approach to asthma treatment and management.
•Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.
SAMPLE ANSWER
Asthma
Introduction
Asthma disease is a global health concern as it affects about 25.7 Americans. The healthcare complication is reported to be the leading cause of hospitalizations and childhood mortality. Asthma pathophysiology involves the alterations of the normal immune response of the respiratory system. The immune response is often triggered by allergens such as pollen, mould, dust, spores, cold, and preservatives. When a trigger is inhaled, it causes allergic reaction such as inflammation and activation of cells to overproduce mucus. This makes it hard to inhale or to exhale. The asthmatic attack is usually mild, but it could be fatal in some cases. The treatment focuses on effective ways to relieve the health complication and to improve the patient quality of life (Simon, 2013).
Quick relief of asthmatic attack
The respiratory system is very vital for survival. The quick relief treatment is mainly used to clear the airways to improve inhalation process. The main medication used for this purpose is the short acting beta 2 agonist administered through inhalation. The medication causes the respiratory tract muscles to relax and to open up. The medication causes reduction of cytokines and cellular level adhesion. Intravenous corticosteroids can also be administered, and have been found to be effective in reducing the rate of inflammation. People diagnosed with asthma should take the quick relief medication once they notice first symptom. Additionally, the pMDI inhalers should be carried everywhere they go, because one cannot predict the environment or weather condition (Barclay, Jeffres, & Bhakta, 2011).
Long-term medication
This type of medication is taken daily to manage the asthmatic attack symptoms. The most common medication is inhaled corticosteroids including Asmanex and Fluticasone. The mechanism of this medication is that it relaxes the muscles and reduces the excessive production of mucus. The side effects include dizziness, nausea, and vomiting. Other types of long-term medication include oral medication Leukotriene such as Montelukast as well as Zafirlukast. However, this medication is not commonly used due to its side effects such as hallucinations and anxiety. The combination inhalers are also used as long-term medication. These medication involved combination therapy of corticosteroids and beta agonists. The medication counteracts the effects of allergens, which lead to blockage of lung airways. The major side effects is oral thrush, skin rash and hormonal disturbances (Bonagura, 2013)
Stepwise treatment
Patient healthcare condition determines the stage or type of treatment:
Step 1 refers to mild and intermittent stage. The clinical manifestation is managed using the short-acting bronchodilator or beta2 agonist. If the condition is not stable within two weeks, the physician could consider using the second line of therapy. Step 2 is also referred to as second line therapy. This stage, the attack is persistent but mild. The medication recommended is low dose corticosteroids, which is usually inhaled, taken once per day, and according to the disease symptoms. The alternative medication is leukotriene modifiers and theophylline. Step 3 also refers to persistent symptoms, which present daily. Evidence based research indicates that the combination therapy of low dose corticosteroid and long acting beta2 agonist improves the patient quality of life. The outcome has also been shown to improve with use of combination therapy of theopylline or leukotriene modifiers with low dose of inhaled corticosteroids. Step 4 includes health care condition that is continual. The recommended medication is high dose of long acting beta 2 agonist. Inhaled corticosteroids also improve lung function effectively. If necessary, the oral corticosteroids can be used but under the instructions of a specialist (Simon, 2013).
Disease Management
The patient should be educated on the various systems of inhaled medication such s roto-systems, inhalers and nebulizers. The patient should advise on ways to maintain hygiene of the medication administration tools, and ways to monitor the drug level so that the patient does not run out. The patient should also reduce exposure to asthma attack. This includes installation of air conditioner to control allergens in the house such as pollen, dust, spores, or weeds. The patient should exercise frequently and maintain healthy diet to maintain healthy weight. The diseases associated with exacerbation of asthmatic attack include gastro-esophageal reflux disease (GERD). Research indicates that the acid reflux normally cause inflammation of airways, making them more susceptible to allergic attack. These measure controls the troublesome symptoms, avoid recurrent and exacerbations of asthma, improves lung function, causing reduction of cost of care (Clayton, 2014).
References
Barclay, S., Jeffres, M., & Bhakta, R. (2011). Educational Card Games to Teach Pharmacotherapeutics in an Advanced Pharmacy Practice Experience. American Journal Of Pharmaceutical Education, 75(2), 33. https://ww.doi:10.5688/ajpe75233
Bonagura, D. (2013). The Importance of the Asthma Control Test in Asthma Management. Journal Of Asthma & Allergy Educators, 4(3), 138-139. doi:10.1177/2150129713486898
Clayton, S. (2014). Adherence to asthma medication. Nurse Prescribing, 12(2), 68-74.
Simon, L. (2013). Urban Youth’s Perspectives on Asthma and Asthma Management: Educational Implications. Journal Of Asthma & Allergy Educators, 4(3), 103-111. doi:10.1177/2150129713475362
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