Asthma Stepwise Management
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.
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.
Solution.
Asthma Stepwise Management
Introduction
Asthma is a disease that affects both adults and children and affects the respiratory system. Only well-qualified caregivers avail treatment to the patients affected by the ailment. Most patients require immediate treatment, thus making it mandatory that minor symptoms be recognized and be distinguished from severe, life-threatening symptoms. However, it has been identified that a trigger induces asthma attacks and symptoms. For this reason, advanced caregivers must assist the affected people to determine these triggers and advice on the appropriate measures to combat the ailment. Nevertheless, the patient should be advised of methods that quick relief and control options, impact asthma drugs have on admitted patients, the stepwise method for controlling and treating patients, and how this approach helps the patient as well as the caregiver in obtaining and maintaining control of the ailment.
Treatment Alternatives and Stepwise Management
Both the quick and long-term treatment options for asthma are administered on a day to day terms with purposes of maintaining as well as achieving control of this persistent ailment. Some of the long-term medication for the disorder includes the corticosteroids. The drugs block the late-phase reaction to an allergen. The medicine also reduces the hyper-responsiveness of the airway as well inhibiting the inflammatory cell activation and migration. The corticosteroids are the most effective and potent anti-inflammatory drugs. The inhaled corticosteroids are used in controlling asthma on a long term period. However, regardless of their effectiveness, the inhaled form of medication is associated with side effects, especially at lower doses. For example, thrush, commonly known as a yeast ailment in the mouth, as well as hoarseness may be experienced by the patient. However, the side effect can be avoided by embrace the practice of mouth gargling after using the inhaler. Additionally, the spacer device accompanied with the metered dose inhalers can also be used in preventing the side effects. Additional, the thrush side effect can be cured when the patient is prescribed with the antifungal lozenge. Asthma is best treated by adopting the stepwise approach management.
Stages of Stepwise Management
Step one of the approach applies to persons of all ages. The medication offered in this step is the short acting beta agonist, for example, the albuterol prn (Holt, 2009). If this drug does not improve the patient’s ill status for more than two days, the patient should put into consideration the option of visiting another other treatment options. The second step also applies to persons of all ages. The preferred medication at this level is the low-dose inhaled steroid. For individuals aged zero to four, they are advised to consider referral option, particularly if the diagnosis is in doubt. Step three applies for a person aged 12 years and above (Holt, 2009). The preferred prescription is the low-dose inhaled steroid together with the long-acting beta agonist. For individuals aged 0-4 years, they should be administered with the medium-dose inhaled steroid. Step four is also adopted for individuals aged 12 years and above. The medium-dose inhaled steroids, as well as the long-acting beta agonist, are most preferred in this case (Holt, 2009).
Step five of the step approach treatment is also adopted for patient aged 12 years and above. At this level, the patient should not be prescribed with the medium dose inhaled steroid, rather, they should be prescribed with the long-acting beta agonist (Thomas, Lemanske & Jackson, 2011). Especially, the omalizumab should be considered if the disorder is accompanied with other allergies. Omalizumab should be taken into account in case allergies are present. For patients aged five to eleven, similar prescriptions as those in the previous steps are adopted.
Relevance of Stepwise Management
Although there are other approaches used in the management and control of the Asthma, just like other ailments, the stepwise approach assists both the caregiver and the patient in making decisions related to drug therapy plans (Arcangelo & Peterson, 2013). The decision made are based on some factors, for example, the condition of the patient as well as whether the patient as allergies or not.
Conclusion
In conclusion, the
patient should be advised of methods that quick relief and control options,
impact asthma drugs have on admitted patients, the stepwise method for controlling
and treating patients, and how this method
helps the patient as well as the caregiver in obtaining and maintaining control
of the ailment.
References
Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.
Chapter 25, “Asthma” (pp. 346–364)
Holt, T. (2009). Stepwise approach to asthma management. RT: The Journal For Respiratory Care Practitioners, 22(5), 12-17.
Thomas, A., Lemanske, J. F., & Jackson, D. J. (2011). Reviews and feature article: Approaches to stepping up and stepping down care in asthmatic patients. The Journal Of Allergy And Clinical Immunology, 128915-924. doi:10.1016/j.jaci.2011.07.014
