Unit 1: Management of the Asthma Patient
Unit 1 Management of the Asthma Patient
Diagnosis:
Currently, the patient, a 16-year-old girl, has mild persistent asthma that is well managed. Asthma control is measured by how often symptoms happen, waking up at night, using rescue medicine, and limiting activities, according to the National Asthma Education and Prevention Program (NAEPP) and the Global Initiative for Asthma (GINA). According to the fact that she takes albuterol three times a week and only has nighttime symptoms twice a month, her mild persistent asthma is still “well-controlled” (Mansur & Prasad, 2023).
Management and Rationale:
The patient is taking albuterol as needed along with beclomethasone dipropionate (Qvar) 40 mcg once every two days as maintenance treatment. As long as she can control her symptoms well and does not have any bad effects, her present treatment plan should be kept up. To keep things under control, it is important to stress compliance and the right way to use an inhaler. Step-down treatment is not yet recommended due to her intermittent symptoms. If symptoms get worse or she wakes up more than twice a month during the night, she might want to switch to a low-dose inhaled corticosteroid (ICS) plus a long-acting beta-agonist (LABA) (Di Cicco et al., 2021).
Prescription Plan:
The patient will keep using beclomethasone dipropionate (Qvar RediHaler) 40 mcg/inhalation, taking one puff by mouth twice a day and being told to rinse her mouth out well after each use to avoid getting oral candidiasis (Scotney et al., 2021). She will use albuterol sulfate (ProAir HFA) 90 mcg/inhalation to treat immediate symptoms. She will take two puffs by mouth every four hours as needed for wheezing or shortness of breath, and she may also take two puffs 15 minutes before exercise to avoid bronchospasm caused by exercise.
Patient Education:
Asthma education should focus on sticking to a treatment plan, using an inhaler correctly, and recognizing trends of symptoms that mean asthma control is getting worse. So that she does not develop thrush, the patient should be told to rinse her mouth out after each dose of beclomethasone (Mansur & Prasad, 2023). People who are known to be triggers should stay away from things like dust, pollen, and smoke. The patient should know how to use a peak flow meter at home and keep an asthma log to record their symptoms and how often they use their inhaler. She should be told to receive a flu shot every year and keep up with normal physical activity as long as she can handle it.
Follow-Up and Referral:
A follow-up visit in 3 months is suggested to check on asthma control, inhaler technique, and drug compliance again (Di Cicco et al., 2021). If the patient’s asthma becomes worse or flares up often, they may need to see an asthma expert or pulmonologist. Patients should also be taught when to seek emergency care, like when symptoms interfere with speech or activity, or when shortness of breath worsens or the rescue inhaler is less effective.
References
Di Cicco, M. E., Leone, M., Scavone, M., Del Giudice, M. M., Licari, A., Duse, M., Brambilla, I., Ciprandi, G., Caffarelli, C., & Tosca, M. (2021). Intermittent and mild persistent asthma: how therapy has changed. PubMed, 92(S7), e2021523. https://doi.org/10.23750/abm.v92is7.12422
Mansur, A. H., & Prasad, N. (2023). Management of difficult-to-treat asthma in adolescence and young adults. Breathe, 19(1), 220025. https://doi.org/10.1183/20734735.0025-2022
Scotney, E., Burchett, S., Goddard, T., & Saglani, S. (2021). Pediatric problematic severe asthma: Recent advances in management. Pediatric Allergy and Immunology, 32(7), 1405–1415. https://doi.org/10.1111/pai.13543
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Instructions
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
2. Classroom Participation
Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.
Initial Response
Instructions:
You are seeing a 16-year-old patient previously diagnosed with mild persistent asthma for a routine follow-up visit.
- She is currently taking beclomethasone dipropionate (Qvar) MDI 40mcg/inhalation one puff twice daily for asthma maintenance and using albuterol (ProAir HFA) MDI 90mcg/inhalation 2 puffs every 4 hours as needed for shortness of breath or wheezing.
- In the last two months she reports using her albuterol inhaler during daytime hours an average of three times per week.
- She reports awakening at night with asthma symptoms about twice per month.
- She does not feel that she has any limitations to her activity due to asthma symptoms.
- Upon examination today her blood pressure is 110/76, heart rate is 68, respiratory rate is 18, O2 saturation is 96% on room air, and temperature is 97.8. Her lung sounds are clear, heart rhythm is regular, and skin is pink and dry.
Please develop a discussion post that responds to each of the following prompts. Where appropriate your discussion needs to be supported by scholarly resources. Be sure to include in-text citations in the context of the discussion and provide a full reference citation at the end of the discussion post:
- Provide your diagnosis.
- Discuss how you would manage the patient’s current asthma regimen and provide a rationale supported by scholarly reference for your treatment plan.
- Include your specific prescription(s) for the patient. (This must include the medication name, dose, route, and frequency as well as any special instructions that apply as you would include when writing a prescription).
- Describe the patient education you would provide in relation to your treatment plan.
- Provide your plan for follow-up and/or referral (if indicated)
Please be sure to validate your opinions and ideas with citations and references in APA format.