NURS 6521 Week 3 Assignment: Asthma and Stepwise Management

• [Stepwise Approach to Asthma Management.]
• Walden University
• [Asthma]
• Asthma is a chronic disorder estimated to occur in 1-11 children, and 1-12 adults in the United States (Rosenthal & Burchum, 2018). Signs and symptoms include chest tightness, breathlessness, cough, dyspnea and wheezing. NURS 6521 Week 3 Assignment: Asthma and Stepwise Management
• Causes:
• Allergens like pollen, dust mites, molds and animal dander are common triggers to asthma attacks, other ongoing health conditions are additional triggers—obesity, obstructive sleep apnea and acid reflux (American College of Allergy, Asthma & Immunology. Org.(2020).

Asthma attacks could also be triggered by extreme weather conditions, stress, air irritants like smoke, chemical fumes and noxious odors. Cold and sinus infections could exacerbate asthma.

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• Asthma management using stepwise approach
• The goal of asthma treatment is identifying and avoiding allergen triggers, and initiation effective drug therapy for persistent asthma to reduce frequency of severe asthma attacks (Acaai.org, 2020). NURS 6521 Week 3 Assignment: Asthma and Stepwise Management
• Stepwise approach has proven effective in asthma management, with the goal of reducing impairments and risk of reduction while using less amount of medications (National Institute of health. gov, 2007).
• The use of stepwise method is recommended in the EPR 3, as one of the best practice n asthma management (Holt, 2009).

Stepwise approach to asthma management allows the treatment to be stepped up  or stepped down, or modified as control of disease is achieved and to prevent further exacerbation (Holt, 2009). NURS 6521 Week 3 Assignment: Asthma and Stepwise Management

• [Asthma management with medications]
• Quick-relief asthma treatment: Use of short or quick relief medications at initial sign of symptoms:-
• Bronchodilators–Short-acting inhaled beta2-agonists (SABA) examples are albuterol, levalbuterol.
• Anti-inflammatory drugs—Glucocorticoids.
• Anticholinergics-Atropine, Cogentin, dicyclomine.
• Long-term control treatment: Taken daily to prevent symptoms & attacks:-
• Anti-inflammatory drugs:–Glucocorticoids (oral & inhaled), leukotriene modifiers (Montelukast (Singulair),

Asthma could equally be managed with non-pharmacological methods— through patient education and caution to allergen triggers.

• The stepwise approach to asthma therapy is designed to step up care to regain control or stepped down for patients who have maintained control for a good length of time. The number of medications are increased or reduced when necessary to achieve and maintain control of disease process (NIH.gov, 2007). The control of asthma are two-fold—reduction of impairment and risk.

Reducing impairment comprises the prevention of chronic and persistent symptoms, maintenance of near normal lung function and activities and meeting patients/families care expectations and satisfaction. Risk reduction implies prevention of recurrent and persistent asthma attacks, less emergency visits, pharmacology use with less or minimal adverse effects (Nih.gov, 2007).

• 
• [Stepwise asthma approach figure 1]
• Stepwise approach to asthma management is an evidence-based module of treatment that varies depending on frequency and severity of patient’s symptoms, disruption of activities of daily living, lack of sleep from symptoms, and increased of use of rescue medications (Holt, 2009).
• Achieve and maintain control of symptoms
• Prevention of asthma exacerbation
• Maintain pulmonary function as close to normal as possible.
• Minimize frequent emergency room visits and hospitalization
• Avoid adverse effects of asthma medications
• Promote and maintain normal activities of daily living.
• NURS 6521 Week 3 Assignment: Asthma and Stepwise Management

Follow up appointment should be 3 months if control is achieved, or after 1 month when not adequately controlled. The APRN should endeavor to monitor any pitfall and correct if present. Patient should be seen monthly, health education provided. Once control is achieved, follow up can be after 3 months.

• References

American College of Allergy, Asthma & Immunology. Org.(2020). Asthma treatment. Https://acaai.org/asthmaotreatment/

Holt, T.O. (2009). Stepwise approach to asthma management. Https://eds.a-ebscohost-com.waldenulibrary.org/eds/pdfviewer/

National Institute of health. gov.(2007). Stepwise approach for managing asthma in youths 12 years of age and adults. Https://www.ncbi.nlm.nih.gov/books/NBK7222/

Rosenthal, L.D. & Burchum. J.R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier

Assignment: Asthma and Stepwise Management

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

• Reflect on 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.
• Consider how you might apply the stepwise approach to address the health needs of a patient in your practice.
• Reflect on how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. NURS 6521 Week 3 Assignment: Asthma and Stepwise Management

By Day 7 of Week 3

Create a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following:

• Describe long-term control and quick relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient.
• Explain the stepwise approach to asthma treatment and management for your patient.
• Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.

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