Assignment: Asthma And Stepwise Management NURS 6521

Assignment: Asthma and Stepwise Management NURS 6521

Assignment: Asthma and Stepwise Management NURS 6521

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.

 

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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:

 

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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

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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?

 

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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.

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Name: NURS_6521_Week3_Assignment_Rubric
Grid View
List View
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