üFor the past 20 years, asthma has emerged as a major public health issue in the United States
üI5 million Americans have been diagnosed with asthma. Asthma and Stepwise Management Assignment
üAnnually, 5,500 people die from asthma (National Asthma Education and Prevention Program, n.d).
üThe rates of asthma-related hospitalizations, deaths, and ED visits are high among African Americans.
üAsthma-related costs have increased to 12.7 billion dollars since 1980s(National Asthma Education and Prevention Program, n.d).
üAsthma control can be achieved with proper care and adherence to medications
ü
üThe long term goal of asthma is to reduce the severity and frequency of occurrence of asthma symptoms (Arcangelo et al (2017)
üHowever, medication compliance is mandatory to achieve long term control
üThe drugs used for the long term control of asthma based on recommendations by the FDA are LABA(Long-acting beta agonists, inhaled corticosteroids(ICS), and leukotriene modifiers(Aalbers, Vogelmeier & Kuna, 2016). Asthma and Stepwise Management Assignment
üICS are the most effective, they act by preventing airways hyper responsiveness
üSide effects of ICS that patients must be aware of include; hoarseness, oral thrush, easy bruising, and osteoporosis.
üQuick relief drugs are commonly known as recue drugs since they are used to manage symptoms during an asthma attack such as shortness of breathe, wheezing and severe coughs.
üQuick relief medications act by relaxing the airway muscles, they have a fast and short duration of action to improve breathing (Khalid, 2015).
üNPs must educate all asthmatic patients to keep a rescue inhaler Asthma and Stepwise Management Assignment
üExamples of quick relief medications include metaproterenol, albuterol, bitolterol, pirbuterol
üCommon side effects that NPs must know and educate patients about include; tremors, anxiety, restlessness, an irregular heartbeat, and headaches(Arcangelo et al (2017).
üA patient’s asthma management approach should be adjusted based on asthma management guidelines
üAccording to Khalid (2015), the stepwise approach to asthma management ensures the initiation of a more intense and rigorous approach to therapy before stepping down to a lesser therapy
üThe stepwise approach to asthma management also promotes rapid control of symptoms before stepping down Asthma and Stepwise Management Assignment
üHas six steps:
üStep 1-a patient with intermittent asthma is prescribed a short-acting beta agonist such as an albuterol inhaler, inhaled 4-6 hourly as required.
üStep 2-prescribe a low dose ICS such as Beclomethasone HFA 80-240 µg Inhaled once
üStep 3-prescribe either a low dose LABA (Salmeterol 50 mcg to be inhaled twice daily. ) or medium-dose ICS ((Fluticasone HFA/metered dose inhaler 264-440 µg)
üStep 4- prescribe both medium dose ICS (Fluticasone HFA/metered dose inhaler 264-440 µg) and LABA(50mcg)
üStep 5-prescribe a LABA (Salmeterol 50 mcg) and a high-dose ICS (Fluticasone HFA/metered dose inhaler >440 µg)
üStep 6- prescribe a LABA (Salmeterol 50 mcg), an oral corticosteroid (monteleukast once daily), and a high-dose ICS (Fluticasone HFA/metered dose inhaler >440 µg). Asthma and Stepwise Management Assignment
üThe drugs prescribed by a NP using the stepwise approach to asthma management is determined by a patient’s stage of asthma
üAccording to Trevor & Chipps (2018), the stepwise approach guarantees healthcare providers with the ability to assess the level or extent of a patient’s symptom control
üHealthcare providers can also determine the effectiveness of prescribed drugs, potential side effects that can prevent compliance and a patient’s level of adherence
üA provider can use this information to either step up or step therapy
üPatients may benefit from continuous health education that happens in each stage that promotes a better control of symptoms.
ü
üAalbers, R., Vogelmeier, C., & Kuna, P. (2016). Achieving asthma control with ICS/LABA: a review of strategies for asthma management and prevention. Respiratory medicine, 111, 1-7.
üArcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins. Chapter 25, “Asthma” (pp. 377-392) Asthma and Stepwise Management Assignment
üKhalid, A. N. (2015). Stepwise management of asthma. In the International forum of allergy & rhinology (Vol. 5, No. S1, pp. S41-S44).
üNational Asthma Education and Prevention Program, Third Expert Panel on the Diagnosis and Management of Asthma. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Bethesda (MD): National Heart, Lung, and Blood Institute (US); 2007 Aug. Section 4, Stepwise Approach for Managing Asthma in Youths ≥12 Years of Age and Adults. Retrieved 16th December 2020 from: https://www.ncbi.nlm.nih.gov/books/NBK7222/
üTrevor, J. L., & Chipps, B. E. (2018). Severe asthma in primary care: identification and management. The American Journal of Medicine, 131(5), 484-491. Asthma and Stepwise Management Assignment
ü
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 ones. 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. Asthma and Stepwise Management Assignment
Photo Credit: Photo Library / Getty Images
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.
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:
To submit your completed Assignment for review and grading, do the following:
Excellent | Good | Fair | Poor | |
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Describe the 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. |
27 (27%) – 30 (30%)
The presentation clearly and accurately describes in detail the long-term control and quick relief treatment options for the asthma patient from their practice.
The presentation clearly and accurately describes in detail the impact these drugs might have on their patient. |
24 (24%) – 26 (26%)
The presentation accurately describes the long-term control and quick relief options for the asthma patient from their practice.
The presentation accurately describes the impact these drugs might have on their patient. Asthma and Stepwise Management Assignment |
21 (21%) – 23 (23%)
The presentation inaccurately or vaguely describes the long-term control and quick relief options for the asthma patient from their practice.
The presentation inaccurately or vaguely describes the impact these drugs might have on their patient. |
0 (0%) – 20 (20%)
The presentation inaccurately and vaguely describes the long-term and quick relief options for the asthma patient from their practice, or is missing. Asthma and Stepwise Management Assignment
The presentation inaccurately and vaguely describes the impact these drugs might have on their patient, or is missing. |
Explain the stepwise approach to asthma treatment and management for your patient. |
27 (27%) – 30 (30%)
The presentation clearly and accurately explains in detail the stepwise approach to asthma treatment and management for their patient.
|
24 (24%) – 26 (26%)
The presentation accurately explains the stepwise approach to asthma treatment and management for their patient.
|
21 (21%) – 23 (23%)
The presentation inaccurately or vaguely explains the stepwise approach to asthma treatment and management for their patient.
|
0 (0%) – 20 (20%)
The presentation inaccurately and vaguely explains the stepwise approach to asthma treatment and management for their patient.
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Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific. |
27 (27%) – 30 (30%)
The presentation clearly and accurately explains in detail how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.
The presentation provides accurate and detailed examples to support the explanation provided. |
24 (24%) – 26 (26%)
The presentation accurately explains how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Asthma and Stepwise Management Assignment
The presentation provides accurate examples to support the explanation provided. |
21 (21%) – 23 (23%)
The presentation inaccurately or vaguely explains how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.
The presentation provides inaccurate or vague examples to support the explanation provided. |
0 (0%) – 20 (20%)
The presentation inaccurately and vaguely explains how stepwise management assists health care providers and patients in gaining and maintaining control of the disease, or is missing.
The presentation provides inaccurate and vague examples to support the explanation provided, or is missing. |
Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. |
5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
|
4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
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3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
|
0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
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Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors
|
4 (4%) – 4 (4%)
Contains a few (1–2) grammar, spelling, and punctuation errors
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3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) grammar, spelling, and punctuation errors
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0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
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Total Points: 100 |
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