NURS 6521 week 3 Assignment: Asthma and Stepwise Management

• The Stepwise Management of Asthma
• Introduction
• A stepwise approach to asthma management can involve both step-down or step-up therapies.
• Step-down therapy entails initiating a high-dose treatment and reducing it during successive visits if control has not been adequately accomplished (Falk, Hughes, & Rodgers, 2016). The reverse is true for the step-up approach.

Asthma affects both children and adults and is a major health concern globally. The prevention of symptoms by controlling airway hyperreactivity and inflammation is the principal goal of treatment.

• Long-term Control and Quick Relief Treatment
• Long-term control involves taking medication on a daily basis to accomplish and maintain the control of chronic asthma.
• Common medication used in achieving long-term control include Advair, QVAR, Flovent, Pulmicort, and Singulair (Bonewit-West, Hunt, & Applegate, 2015).
• Contrarily, quick relief medications afford fast relief for congested or tight airways and associated symptoms of wheezing, chest tightness, and coughing that attend asthma.
• Medications used for quick relief include Maxiar, Proventil HFA, ventolin HFA, Xopenex, albuterol, and ProAir HFA.

Long-term medications are broadly categorized as corticosteroids, immunomodulators, leukotriene modifiers, and long-acting beta agonists. Quick relief medicines, on the other hand, relieve the symptoms of asthma immediately they happen.

• Potential Impacts of Medication on Patients
• Medications for both long-term control and the quick relief of asthma can have side effects on patients.
• Inhaled corticosteroids prevent symptoms, but do not relieve an attack when it has begun (Gibson, 2019).
• Possible side effects of inhaled corticosteroids include oral candidiasis, sore throat and mouth, short-term dysphonia, reduced bone density (adults), cataract, glaucoma, spasms of the trachea (reflex coughs), and slightly reduced growth in children (Walsh, 2019).
• Beta antagonists (short- and long-acting) can cause increased pulse rate, anxiety, rash, dizziness, and headache.

Gargling and rinsing after using inhaled corticosteroids can prevent local adverse effects. The side effects of beta antagonists resolve quickly. However, rescue inhaler should not be overused, as doing so increases the risk of a severe attack.

• The Stepwise Approach – Patients
• The stepwise approach to the treatment and management of asthma can involve a step-down therapy or step-up therapy (Bernstein& Mansfield, 2019).
• Step-up therapy involves beginning with low-dose treatment that is increased gradually until optimal control is achieved.
• Step-won therapy, contrarily, involves starting with a higher dose that is reduced gradually as stability in the control of asthma is achieved.
• Step-down therapy seems to be more effective and beneficial in the treatment and management of asthma.

Doctors often recommend following the step-down approaches for those with confirmed cases of asthma. This is because it makes it possible to reduce the exposure to potentially detrimental impacts of medication, in addition to simplifying the medication regimen of the patient. This encourages better adherence.

• The Step-Wise Approach-Care Providers
• The step-wise approach helps both care providers and patients to gain and maintain control of asthma.
• Health care providers use the approach to complement, not replace, clinical decision-making needed in meeting the needs of individual patients (Craig, 2014).
• Alternative treatments are often used and, in the event of inadequate response, these are discontinued and the preferred treatment used before stepping up.
• The stepwise approach helps both care providers and patients to control and manage effectively.
• Conclusion
• Asthma is often an underdiagnosed and undertreated condition.
• The widespread availability and use of inhaled corticosteroids has reduced adverse events and improved outcomes.
• The stepwise approach – which includes step-up and step-down therapies – is one of the methods used in achieving the control, management, and treatment of the condition.
• The approach should be used strictly as an complement, and not as a replacement for care decisions required to meet the needs of individual patients.
• References
• Falk, N. P., Hughes, S. W., & Rodgers, B. C. (2016). Medications for chronic asthma. American Family Physician, 94(6), 454-462.
• Bernstein, J. A., & Mansfield, L. (2019). Step-up and step-down treatments for optimal asthma control in children and adolescents. Journal of Asthma, 56(7), 758-770.
• Craig, T. J. (2014). Physician implementation of asthma management guidelines and recommendations: 2 case studies. Journal of the American Osteopathic Association, 114(11), eS4-eS15.
• Bonewit-West, K., Hunt, S., & Applegate, E. (2015). Today’s medical assistant: Clinical & administrative procedures. London, UK: Elsevier Saunders.
• Gibson, P. (2019). Monitoring asthma. Boca Raton, FL: Taylor & Francis.
• Walsh, B. K. (2019). Neonatal and pediatric respiratory care. St. Louis, MO: Elsevier.

Assignment: Asthma and Stepwise Management

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.

Photo Credit: 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.

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.

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.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK3Assgn+last name+first initial.(extension)” as the name.
• Click the Week 3 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 3 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK3Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.