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Assignment: Asthma And Stepwise Management NURS 6521

Assignment: Asthma and Stepwise Management NURS 6521

Walden University Assignment: Asthma And Stepwise Management NURS 6521-Step-By-Step Guide

 

This guide will demonstrate how to complete the Walden University  Assignment: Asthma And Stepwise Management NURS 6521 assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

 

How to Research and Prepare for Assignment: Asthma And Stepwise Management NURS 6521

 

Whether one passes or fails an academic assignment such as the Walden University  Assignment: Asthma And Stepwise Management NURS 6521 depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

 

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

 

How to Write the Introduction for Assignment: Asthma And Stepwise Management NURS 6521

 

The introduction for the Walden University  Assignment: Asthma And Stepwise Management NURS 6521 is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

 

How to Write the Body for Assignment: Asthma And Stepwise Management NURS 6521 

 

After the introduction, move into the main part of the Assignment: Asthma And Stepwise Management NURS 6521 assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

 

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

 

How to Write the Conclusion for Assignment: Asthma And Stepwise Management NURS 6521

 

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

 

How to Format the References List for Assignment: Asthma And Stepwise Management NURS 6521

 

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for Assignment: Asthma and Stepwise Management NURS 6521

3.LABAs  that consist of drugs such as salmeterol  have a mode of action that involves activation of adrenoceptors at the pre-junctional β2 thus reducing release of acetylcholine.

₋They bring about a therapeutic effect through reducing the frequency of asthma attacks as well as the symptoms and improving lung function. However there are side effects as well as contraindications associated with these drugs and it is noted that they shouldn’t be used alone for asthma treatment as they are linked to increased risk of asthma attacks and asthma related deaths.

4.Inhaled corticosteroids that consist of drugs such as budesonide are also involved in asthma management and their mode of action  occurs through decreasing activity of inflammatory cells, edema in the airways and inflammatory mediators thus suppressing inflammation altogether.

₋Their therapeutic effect occurs through improving the body’s response to bronchodilators and also the potential of a person getting dyspnea. However, it should be contraindicated to patients who have tested positive for candida albicans and a side effect associated to it is development of candidiasis.

(Rosenthal & Burchum, 2021).

Introduction

Asthma is a chronic, inflammatory disease which affects the airways. It is associated with various symptoms such as wheezing, difficulty in breathing, chest pain, and cyanosis in severe cases. It is very prevalent in America where 22 million people are affected. The situation raises hospitalization levels to more than 497,000 annually (Kirenga et al., 2018). With such a high number, the country is significantly affected both economically and socially. Many children missed school days due to asthma and some caregivers are also forced to leave work to take care of their sick children. As productivity of the country lowers, a lot of money is used in managing the disease (Rothe et al., 2018). However, treatment options have been improved to address the situation.

Treatment Options

Both quick-relief and long control medicines are used in treating asthma. Long-term control medicines (also called controller medicines or maintenance medicines). Long-acting beta-adrenergic (LABA) is one of the quick relief medication used. The LABAs help in providing long-term control of symptoms (Kirenga et al., 2018). Inhaled corticosteroids (ICS) are commonly used as anti-inflammatory drugs because they reduce inflammation caused by a vast diversity of inflammatory mediators (Yawn & Han, 2017). Rothe et al. (2018) highlight omalizumab (Xolair) as the most common Immuno-modulators used to prevent the binding of IgE to its receptor and in turn, inhibit IgE-mediated asthma from cascading before it begins.

Asthma Stepwise Management

STEP 1. Step one and two are recommended for all ages. In asthma treatment, inhaled corticosteroids (ICS) are commonly used as anti-inflammatory drugs because they reduce inflammation caused by a vast diversity of inflammatory mediators (Yawn & Han, 2017). STEP 2. Referrals can be considered for ages between 0-4 (White et al., 2018). This treatment is recommended for patients who show no improvement in step one. The intensity of the medications are increased, and other treatment options are introduced to address the problem. According to Yawn & Han (2017), leukotriene receptor antagonists (LTRAs) are introduced as the alternative category of drugs because they help in blocking leukotrienes from binding to the proinflammatory cells in the airways. Most commonly used LTRAs are montelukast, which is effective in allergic asthma.

STEP 3. According to Yawn and Han (2017), this step applies for ages above 12 years. At this stage, either the ICS dose is increased, or a long-acting beta-adrenergic (LABA) is added. The LABAs help in providing long-term control of symptoms (Kirenga et al., 2018). Some of the most commonly used combinations of LABAs and ICS (ICS/LABA) are fluticasone + salmeterol (available as a dry powder inhaler) and formoterol + budesonide (available as an HFA inhaler) (Yawn & Han, 2017). STEP 4. Applies for ages above 12 years. Also, patients who experience recurring severe exacerbations requiring ED visits, oral prednisone, or hospitalizations should be considered for this step. The same applies for patient of ages between 5 and 11.

STEP 5. Applies for ages above 12 years. For ages between 5-11 years, Rothe et al. (2018) recommends a High-dose inhaled steroid plus long-acting beta-agonist. Alternative can be a High-dose inhaled steroid plus leukotriene blocker. Rothe et al. (2018) highlight omalizumab (Xolair) as the most common Immuno-modulators used to prevent the binding of IgE to its receptor and in turn, inhibit IgE-mediated asthma from cascading before it begins. STEP 6. Applies for ages above 12 years. For age 5-11 years, a High-dose inhaled steroid plus long-acting beta-agonist are preferred. A combination of High-dose inhaled steroid, either long-acting beta-agonist or leukotriene blocker, oral steroid is preferred for age 0-4.

Assistance to Health Care Givers

In 2007, the National Asthma Education and Prevention Program (NAEPP) published its third report, which reinforced the guidelines for the Diagnosis and Management of Asthma. According to Rothe et al. (2018), the Expert Panel recommends that asthma therapy should be aimed at maintaining control of the disease with the least amount of medication which, in turn, minimizes the risks for adverse effects. The stepwise approach increases or decreases the dose administered and also changes them and their frequency till the best medication and with its best amount and frequency of dosage is established. Efforts are focused on suppressing inflammation over the long term and preventing exacerbations (Yokoyama & Yokoyama, 2019).

References

uKirenga, B. J., Schwartz, J. I., de Jong, C., van der Molen, T., & Okot-Nwang, M. (2015). Guidance on the diagnosis and management of asthma among adults in resource limited settings. African health sciences, 15(4), 1189-1199.

uRothe, T., Spagnolo, P., Bridevaux, P. O., Clarenbach, C., Eich-Wanger, C., Meyer, F., & Sauty, A. (2018). Diagnosis and management of asthma–the swiss guidelines. Respiration, 95(5), 364-380.

uYawn, B. P., & Han, M. K. (2017, November). Practical considerations for the diagnosis and management of asthma in older adults. In Mayo Clinic Proceedings (Vol. 92, No. 11, pp. 1697-1705). Elsevier.

uWhite, J., Paton, J. Y., Niven, R., & Pinnock, H. (2018). Guidelines for the diagnosis and management of asthma: a look at the key differences between BTS/SIGN and NICE. Thorax, 73(3), 293-297.

Sample Answer 2 for Assignment: Asthma and Stepwise Management NURS 6521

Introduction

Asthma is a respiratory disorder characterized by swelling and inflammation of the airways making them narrow, and overproduction of mucus. In most patients, the age of onset of asthma is usually during the first 6 years of life accounting for 80% of the reported cases (Azmeh et al., 2020). However, diagnosis of this disorder among pediatric patients is usually very challenging due to the varied symptoms with age (Martin et al., 2022). Some of the common side effects of asthma in both children and adults include chest tightness, shortness of breath, wheezing, and coughing (Papi et al., 2020).

Management of Asthma

The treatment of asthma mainly involves the use of medication. The pharmacological approaches have been divided into two main categories, quick-relief medications and long-term control (Khurana & Jarjour, 2019). To determine which pharmacological approach to use for the patient, it is necessary to find out how severe the patient’s asthmatic condition is (Martin et al., 2022). Several diagnostic tests have been proven to be effective in the diagnosis and grading of asthmatic patients. Such diagnostic tests include spirometry, lung function test, pulse oximetry, peak flow, and nitric oxide measurement (Witt et al., 2022).

For patients with an acute asthmatic attack, quick relief pharmacological management is recommended. Drugs such as oral corticosteroids like prednisolone and short-acting beta blockers like salbutamol are recommended for quick relief management of asthma (Mauer & Taliercio, 2020). However, patients with severe and persistent asthma require long-term therapy, which involves the use of several drugs including corticosteroids, long-acting beta-agonists (LABAs), leukotriene modifiers, and immunomodulators for children above the age of 12 years (Beasley et al., 2020). A stepwise approach is used to determine which medication to use at different stages of the disease.

Stepwise Approach in Asthma Treatment (Children and Adults  ≥12 YEARS)

The stepwise management of asthma varies with age. For patients above the age of 12 years, six main steps are recommended (Khurana & Jarjour, 2019). In the first step, a short-acting beta agonist like salbutamol is recommended. In the second step, a short-acting beta agonist (SABA) is recommended together with a low-dose inhaled corticosteroid (ICS) like fluticasone (Azmeh et al., 2020). In the third step, the patient is administered LABA together with low-dose ICS. The fourth step involves the use of LABA together with medium-dose ICS (Rothe et al., 2018). The fifth step involves the use of SABA together with Long-acting muscarinic antagonists (LAMA) and high-dose ICS-LABA (Papi et al., 2020). In the final step, high-dose SABA is recommended together with high-dose ICS-LABA and oral steroids.

Benefits of Stepwise Approach

The utilization of the stepwise technique in the management of asthmatic patients has displayed significant benefits to both the patient and medical practitioner in the past. For the practitioner, the stepwise approach provides guidance when starting treatment for a given patient who has been recommended for long-term therapy (Mauer & Taliercio, 2020). It also helps the practitioner choose the most effective and well-tolerated medication at an optimal dose, hence reducing the risks of side effects. The practitioner will also be able to effectively adjust the patient’s treatment regimen based on the level of asthma control (Beasley et al., 2020). The benefits to the patient include reduced incidences of recurrent exacerbations of asthmatic symptoms, reduced number of visits to the emergency department and hospitalization, and reduced risks of adverse effects with long-term use of medication (Rothe et al., 2018).

Conclusion

Asthma is a significantly disabling respiratory condition that is characterized by symptoms affecting normal breathing. The diagnosis of this respiratory disorder is usually done by use of lab tests such as spirometry, lung function test, pulse oximetry, peak flow, and nitric oxide measurement. In acute cases, quick relief pharmacological agents are usually used to control the patient’s symptoms. In severe and persistent cases, patients are shifted to long-term therapy that involves the utilization of the stepwise approach to ensure positive outcomes.

References

  • Azmeh, R., Greydanus, D. E., Agana, M. G., Dickson, C. A., Patel, D. R., Ischander, M. M., & Lloyd, R. D. (2020). Update in Pediatric Asthma: Selected Issues. Disease-a-Month66(4), 100886. https://doi.org/10.1016/j.disamonth.2019.100886
  • Beasley, R., Braithwaite, I., Semprini, A., Kearns, C., Weatherall, M., & Pavord, I. D. (2020). Optimal Asthma Control: Time for a New Target. American Journal of Respiratory and Critical Care Medicine201(12), 1480–1487. https://doi.org/10.1164/rccm.201910-1934ci
  • Khurana, S., & Jarjour, N. N. (2019). Systematic Approach to Asthma of Varying Severity. Clinics in Chest Medicine40(1), 59–70. https://doi.org/10.1016/j.ccm.2018.10.004
  • Martin, J., Townshend, J., & Brodlie, M. (2022). Diagnosis and management of asthma in children. BMJ Paediatrics Open6(1), e001277. https://doi.org/10.1136/bmjpo-2021-001277
  • Mauer, Y., & Taliercio, R. M. (2020). Managing adult asthma: The 2019 GINA guidelines. Cleveland Clinic Journal of Medicine87(9), 569–575. https://doi.org/10.3949/ccjm.87a.19136
  • Papi, A., Blasi, F., Canonica, G. W., Morandi, L., Richeldi, L., & Rossi, A. (2020). Treatment strategies for asthma: reshaping the concept of asthma management. Allergy, Asthma & Clinical Immunology16(1). https://doi.org/10.1186/s13223-020-00472-8
  • Rothe, T., Spagnolo, P., Bridevaux, P.-O., Clarenbach, C., Eich-Wanger, C., Meyer, F., Miedinger, D., Möller, A., Nicod, Laurent P., Nicolet-Chatelain, G., Sauty, A., Steurer-Stey, C., & Leuppi, Joerg D. (2018). Diagnosis and Management of Asthma – The Swiss Guidelines. Respiration95(5), 364–380. https://doi.org/10.1159/000486797
  • Witt, A., Douglass, J. A., & Harun, N. (2022). Overview of recent advancements in asthma management. Internal Medicine Journal52(9), 1478–1487. https://doi.org/10.1111/imj.15904

Sample Answer 3 for Assignment: Asthma and Stepwise Management NURS 6521

Introduction

Asthma is a serious condition characterized by narrowed airways that may swell and produce excess mucus. To some patients, asthma could be an ordinary nuisance while some patients may struggle with executing daily activities. Since asthma has no cure, health care professionals should adequately understand the interventions necessary to control it according to symptoms and severity level. As a result, this presentation will describe long-term control and quick-relief options for a patient with asthma. The other crucial area for practitioners is the stepwise approach to asthma management, which entails the stepping up and down of medication doses according to the patient’s condition (Meghdadpour & Lugogo, 2018). The last part describes how the stepwise management helps healthcare providers and patients to manage asthma.

Long-Term Control Options and their Impacts

Effective asthma management requires health care providers and patients to understand and recognize asthma triggers and track a patient’s breathing. There are various long-term control options for a patient with asthma for different characteristics and control methods. Inhaled corticosteroids are taken for some days before their maximum effect is felt. The other option is leukotriene modifiers for relieving asthma symptoms (Ban et al., 2021). Other categories under the long-term options include combined inhalers and theophylline. Broadly, the role of long-term control medications for asthma is to ensure asthma is adequately controlled and there are no unexpected complications. Effective long-term control of asthma also protects a patient from an asthma attack. Some modifiers may cause hallucinations and aggression.

Quick-Relief Treatment Options and Impacts

Quick-relief options for asthma help to relieve asthma symptoms. It is advisable for the health care provider and the patient to work together in planning the best quick-relief option for a patient. Such a plan includes when to take the quick-relief drug(s) and the quantity that should be taken. Short-acting beta agonists help to ease asthma symptoms rapidly. Anticholinergic agents relax the airways, enabling the patient to breathe (Gosens & Gross, 2018). The third category, the corticosteroids, relieves airway inflammation. Short-acting beta agonists are associated with anxiety, irregular heartbeats, and restlessness. Oral and intravenous corticosteroids may also have severe side effects if used for a long period. Hence, they should be used in moderation.

Stepwise Approach to Asthma Treatment and Management

The stepwise approach for asthma management demonstrates how to match the type of intervention/management with the intensity of the condition. As Bernstein and Mansfield (2019) noted, health care providers step up or step down medications as situations oblige. Indeed, the approach typifies patient-centered care where medication responses (treatment and management) are tailored according to patient needs. Short-acting beta-agonists serve all ages and are primarily for intermittent asthma. As a result, their increased use (more than two days weekly) may signify uncontrolled asthma and the need to step up the treatment. The other steps are for persistent stigma, and it is crucial for the patient to consult a health care provider widely if taking high-dose medication.

How Stepwise Management Assists Health Care Providers and Patients

The stepwise management of asthma has many advantages instrumental in helping health care providers to gain and control of the disease. Through the stepwise approach, health care providers increase treatment intensity in discrete steps to obtain symptom control (Beasley et al., 2021). Such an approach facilitates patient-centered responses and reduces possible exacerbation of risks. As Papi et al. (2020) noted, stepwise management optimizes pharmacotherapy due to a significant reduction in side effects profile. It is also an approach that encourages health care providers and patients working together through communication for appropriate patient monitoring and medication adjustments according to the severity of the condition.

Conclusion

Asthma management can be complicated since the disease is incurable and symptoms change often. As a result, health care providers must know when to administer long-term control medications or quick-relief options. When used effectively, long-term control options keep asthma under control while quick-relief options relieve symptoms through rapid response. The stepwise management approach is highly encouraged in asthma management. Through this approach, health care providers step up and step down medications as situations obligate. It is an effective method for disease management since it allows health care providers to monitor patients and make appropriate adjustments on the amount and frequency of medications.

References

›Ban, G. Y., Kim, S. H., & Park, H. S. (2021). Persistent eosinophilic inflammation in adult asthmatics with high serum and urine levels of leukotriene E4. Journal of Asthma and Allergy14, 1219-1230. https://doi.org/10.2147/JAA.S325499

›Beasley, R., Bruce, P., Hatter, L., Braithwaite, I., Semprini, A., Kearns, C., … & Pavord, I. D. (2021). A proposed revision of the stepwise treatment algorithm in asthma. American Journal of Respiratory and Critical Care Medicine204(1), 100-103. https://doi.org/10.1164/rccm.202101-0224LE

›Bernstein, J. A., & Mansfield, L. (2019). Step-up and step-down treatments for optimal asthma control in children and adolescents. Journal of Asthma56(7), 758-770. https://doi.org/10.1080/02770903.2018.1490752

›Gosens, R., & Gross, N. (2018). The mode of action of anticholinergics in asthma. The European Respiratory Journal52(4), 1701247. https://doi.org/10.1183/13993003.01247-2017

›Meghdadpour, S., & Lugogo, N. L. (2018). Medication regimens for managing stable asthma. Respiratory Care63(6), 759-772. https://doi.org/10.4187/respcare.05957

›Papi, A., Blasi, F., Canonica, G. W., Morandi, L., Richeldi, L., & Rossi, A. (2020). Treatment strategies for asthma: Reshaping the concept of asthma management. Allergy, Asthma & Clinical Immunology16(1), 1-11. https://doi.org/10.1186/s13223-020-00472-8

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: 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.

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.

Assignment: Asthma and Stepwise Management NURS 6521

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:

 

Click here to ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT:  Assignment: Asthma and Stepwise Management NURS 6521 

Describe your practice’s long-term control and rapid relief treatment choices for asthma patients, as well as the impact these treatments may have on your patient.
Explain to your patient the step-by-step method to asthma treatment and control.
Explain how stepwise management helps health care providers and patients obtain and maintain illness control. Make your point.
Submission and Grading Details

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.
NOTE: SafeAssign does not accept files over 10MB in size. Please attempt to keep your files under 10MB.

Grading Criteria

Assignment: Asthma and Stepwise Management NURS 6521

To access your rubric:

Week 3 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 3 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 3

To participate in this Assignment:

Week 3 Assignment

What’s Coming Up in Module 3?

 

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In the next module, you will examine diagnoses for patients with potential GI and hepatobiliary disorders. You will also develop a drug therapy plan based on patient history and diagnosis.

Next Week

To go to the next week:

Module 3

 

Module 3: Gastrointestinal and Hepatobiliary Systems

Symptoms of various gastrointestinal (GI) and hepatobiliary disorders often overlap, making diagnosis and treatment challenging. For example, symptoms such as vomiting, constipation, and bloating are non-specific and could also be the result of underlying medical history or current prescription drug use. As an advanced practice nurse, you could be potentially responsible for providing care to a patient who may present with non-specific symptoms related to the gastrointestinal and hepatobiliary systems.

How would you proceed to care for this patient? What type of drug therapy might you recommend, not knowing current medical history or prescription drug use? Are there certain drugs you should avoid in ensuring a drug-drug interaction does not occur? These are the types of questions that may guide you in your role as an advanced practice nurse.

What’s Happening This Module?

Module 3: Gastrointestinal and Hepatobiliary Systems is a 1-week module, Week 4 of the course. In this module, you will examine diagnoses for patients with potential GI and hepatobiliary disorders. You also develop a drug therapy plan based on patient history and diagnosis.

What do I have to do?
When do I have to do it?
Review your Learning Resources
Days 1-7, Week 4
Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
Submit your Assignment by Day 7 of Week 4.
Go to the Week’s Content

Week 4

Assignment: Asthma and Stepwise Management NURS 6521

Week 4: Gastrointestinal and Hepatobiliary Disorders

As an advanced practice nurse, you will likely encounter patients who will present with symptoms affecting the gastrointestinal (GI) tract. Of special note, is the consideration that most symptoms concerning the GI tract are non-specific and therefore, diagnosing diagnoses of the GI tract require thoughtful and careful investigation. Similarly, hepatobiliary disorders may also mirror many of the signs and symptoms that patients present when suffering from GI disorders.

How might you tease out the specific signs and symptoms between these potential disorders and body systems? What drug therapy plans will best address these disorders for your patients?

This week, you examine GI and hepatobiliary disorders. You will review a patient case study and consider those factors in recommending and prescribing a drug therapy plan fo your patient.

Learning Objectives

Students will:

Evaluate diagnoses for patients with gastrointestinal and hepatobiliary disorders
Justify drug therapy plans based on patient history and diagnosis

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

Chapter 64, “Drugs for Peptic Ulcer Disease” (pp. 589–597)
Chapter 65, “Laxatives” (pp. 598–604)
Chapter 66, “Other Gastrointestinal Drugs” (pp. 605–616)
Chapter 80, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 723–743)

Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., . . . Sanya, A. J. (2018). The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology, 67(1), 328–357. Retrieved from https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.29367

 

This article details the diagnosis and management of nonalcoholic fatty liver disease. Review this article to gain an understanding of the underlying pathophysiology as well as the suggested pharmacotherapeutics that might be recommended to treat this disorder.

Week 3: Respiratory System

Asthma and chronic obstructive pulmonary disease (COPD) are significant public health burdens. Currently, more than 25 million people in the United States have asthma (HealthyPeople.gov, 2019). As an advanced practice nurse, you will likely encounter patients who will present with respiratory disorders, including asthma or COPD. Understanding specific treatment protocols as well as the types of pharmacotherapeutics used to treat respiratory disorders is important to ensure the effective and safe delivery of advanced nursing practice.

This week, you will evaluate drug therapy plans for patients who present with asthma and analyze the stepwise approach to asthma treatment and management from a patient in your professional practice.

Reference: HealthyPeople.gov. (2019). Respiratory diseases. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/respiratory-diseases

Learning Objectives

Students will:

  • Evaluate drug therapy plans for asthma
  • Assess the impact of asthma treatments on patients
  • Analyze the stepwise approach to asthma treatment and management

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

  • Chapter 62, “Drugs for Asthma and Chronic Obstructive Pulmonary Disease” (pp. 557–579)
  • Chapter 63, “Drugs for Allergic Rhinitis, Cough, and Colds” (pp. 580–588)

Document: APA Presentation Template

Required Media (click to expand/reduce)

Speed Pharmacology. (2020). Drugs for asthma and COPD (Made Easy) [Video]. https://www.youtube.com/watch?v=-DVZ9pl0rGY
Note:
 This media program is approximately 14 minutes.

Speed Pharmacology. (2017). Antihistamines (Made Easy) [Video]. https://www.youtube.com/watch?v=D5PHANcdA_E&t=25s
Note: 
This media program is approximately 10 minutes.

Optional Resources (click to expand/reduce)

National Heart Lung and Blood Institute. (2007). Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma. Retrieved from http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm

 

This web resource presents guidelines for diagnosing and managing asthma and outlines treatment recommendations for specific age groups.

Also Read:

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NURS 6521 Assignment: Off-Label Drug Use in Pediatrics

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NURS 6521: Basic Pharmacotherapeutic Concepts

Rubric Detail

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Name: NURS_6521_Week3_Assignment_Rubric
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Excellent Good Fair Poor
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.
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.

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.
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.

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.
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.
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
3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) grammar, spelling, and punctuation errors
0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Total Points: 100
Name: NURS_6521_Week3_Assignment_Rubric

Asthma is a chronic, inflammatory disease which affects the airways. It is associated with various symptoms such as wheezing, difficulty in breathing, chest pain, and cyanosis in severe cases. It is very prevalent in America where 22 million people are affected. The situation raises hospitalization levels to more than 497,000 annually (Kirenga et al., 2018). With such a high number, the country is significantly affected both economically and socially. Many children missed school days due to asthma and some caregivers are also forced to leave work to take care of their sick children. As productivity of the country lowers, a lot of money is used in managing the disease (Rothe et al., 2018). However, treatment options have been improved to address the situation.

Both quick-relief and long control medicines are used in treating asthma. Long-term control medicines (also called controller medicines or maintenance medicines). Long-acting beta-adrenergic (LABA) is one of the quick relief medication used. The LABAs help in providing long-term control of symptoms (Kirenga et al., 2018). Inhaled corticosteroids (ICS) are commonly used as anti-inflammatory drugs because they reduce inflammation caused by a vast diversity of inflammatory mediators (Yawn & Han, 2017). Rothe et al. (2018) highlight omalizumab (Xolair) as the most common Immuno-modulators used to prevent the binding of IgE to its receptor and in turn, inhibit IgE-mediated asthma from cascading before it begins.

STEP 1. Step one and two are recommended for all ages. In asthma treatment, inhaled corticosteroids (ICS) are commonly used as anti-inflammatory drugs because they reduce inflammation caused by a vast diversity of inflammatory mediators (Yawn & Han, 2017). STEP 2. Referrals can be considered for ages between 0-4 (White et al., 2018). This treatment is recommended for patients who show no improvement in step one. The intensity of the medications are increased, and other treatment options are introduced to address the problem. According to Yawn & Han (2017), leukotriene receptor antagonists (LTRAs) are introduced as the alternative category of drugs because they help in blocking leukotrienes from binding to the proinflammatory cells in the airways. Most commonly used LTRAs are montelukast, which is effective in allergic asthma.

STEP 3. According to Yawn and Han (2017), this step applies for ages above 12 years. At this stage, either the ICS dose is increased, or a long-acting beta-adrenergic (LABA) is added. The LABAs help in providing long-term control of symptoms (Kirenga et al., 2018). Some of the most commonly used combinations of LABAs and ICS (ICS/LABA) are fluticasone + salmeterol (available as a dry powder inhaler) and formoterol + budesonide (available as an HFA inhaler) (Yawn & Han, 2017). STEP 4. Applies for ages above 12 years. Also, patients who experience recurring severe exacerbations requiring ED visits, oral prednisone, or hospitalizations should be considered for this step. The same applies for patient of ages between 5 and 11.

STEP 5. Applies for ages above 12 years. For ages between 5-11 years, Rothe et al. (2018) recommends a High-dose inhaled steroid plus long-acting beta-agonist. Alternative can be a High-dose inhaled steroid plus leukotriene blocker. Rothe et al. (2018) highlight omalizumab (Xolair) as the most common Immuno-modulators used to prevent the binding of IgE to its receptor and in turn, inhibit IgE-mediated asthma from cascading before it begins. STEP 6. Applies for ages above 12 years. For age 5-11 years, a High-dose inhaled steroid plus long-acting beta-agonist are preferred. A combination of High-dose inhaled steroid, either long-acting beta-agonist or leukotriene blocker, oral steroid is preferred for age 0-4.

In 2007, the National Asthma Education and Prevention Program (NAEPP) published its third report, which reinforced the guidelines for the Diagnosis and Management of Asthma. According to Rothe et al. (2018), the Expert Panel recommends that asthma therapy should be aimed at maintaining control of the disease with the least amount of medication which, in turn, minimizes the risks for adverse effects. The stepwise approach increases or decreases the dose administered and also changes them and their frequency till the best medication and with its best amount and frequency of dosage is established. Efforts are focused on suppressing inflammation over the long term and preventing exacerbations (Yokoyama & Yokoyama, 2019).

References

uKirenga, B. J., Schwartz, J. I., de Jong, C., van der Molen, T., & Okot-Nwang, M. (2015). Guidance on the diagnosis and management of asthma among adults in resource limited settings. African health sciences, 15(4), 1189-1199.

uRothe, T., Spagnolo, P., Bridevaux, P. O., Clarenbach, C., Eich-Wanger, C., Meyer, F., & Sauty, A. (2018). Diagnosis and management of asthma–the swiss guidelines. Respiration, 95(5), 364-380.

uYawn, B. P., & Han, M. K. (2017, November). Practical considerations for the diagnosis and management of asthma in older adults. In Mayo Clinic Proceedings (Vol. 92, No. 11, pp. 1697-1705). Elsevier.

uWhite, J., Paton, J. Y., Niven, R., & Pinnock, H. (2018). Guidelines for the diagnosis and management of asthma: a look at the key differences between BTS/SIGN and NICE. Thorax, 73(3), 293-297.

NURS_6521_Week3_Assignment_Rubric

Excellent Good Fair Poor
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.
Points Range: 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.

Points Range: 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.

Points Range: 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.

Points Range: 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.

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.
Points Range: 27 (27%) – 30 (30%)
The presentation clearly and accurately explains in detail the stepwise approach to asthma treatment and management for their patient.
Points Range: 24 (24%) – 26 (26%)
The presentation accurately explains the stepwise approach to asthma treatment and management for their patient.
Points Range: 21 (21%) – 23 (23%)
The presentation inaccurately or vaguely explains the stepwise approach to asthma treatment and management for their patient.
Points Range: 0 (0%) – 20 (20%)
The presentation inaccurately and vaguely explains the stepwise approach to asthma treatment and management for their patient.
Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.
Points Range: 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.

Points Range: 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.

The presentation provides accurate examples to support the explanation provided.

Points Range: 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.

Points Range: 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.
Points Range: 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
Points Range: 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
Points Range: 0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) grammar, spelling, and punctuation errors
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) grammar, spelling, and punctuation errors
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Total Points: 100