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NR 566 Week 2 Respiratory Treatments Discussion: Asthma (Original Post, Peer Responses) $10.99   Add to cart
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NR 566 Week 2 Respiratory Treatments Discussion: Asthma (Original Post, Peer Responses)
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  • NR 566
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  • Chamberlain College Of Nursing

NR 566 Week 2 Respiratory Treatments Discussion: Asthma (Original Post, Peer Responses) Asthma There are several subjective symptoms found in patients who present to the clinic with asthma. Some o f the subjective findings include coughing, wheezing, shortness of breath, and complaints of chest tig...

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  • June 7, 2022
  • 5
  • 2021/2022
  • Other
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  • nr 566 week 2 respiratory treatments discussion asthma original post
  • peer responses

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  • Chamberlain College Of Nursing
  • NR 566
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NR 566 Week 2 Respiratory Treatments Discussion: Asthma (Original Post, Peer
Responses)
Asthma

There are several subjective symptoms found in patients who present to the clinic with

asthma. Some of the subjective findings include coughing, wheezing, shortness of breath, and

complaints of chest tightness (AAFA, 2021). Objective findings of asthma can include low

oxygen saturation, rapid respirations, and increased mucus with cough (GINA, 2019). Other

objective findings include wheezing heard upon auscultation of the lungs especially on forced

expiration (AAFA, 2021).

It is difficult to be certain of a diagnosis of asthma based on the patient’s history alone as

the symptoms of asthma are also seen in other respiratory diseases (Sano et al., 2019). There are

many phenotypes of asthma, according to GINA (2019) these are usually all characterized by

chronic airway inflammation. There are two key defining features of asthma with the first being

a history of respiratory symptoms present which include wheezing, dyspnea, chest tightness and

cough that vary over time and vary in intensity (GINA, 2019). The second key feature is a

variable expiratory airflow limitation (GINA, 2019). Diagnosis would be done by lung function

tests such as a spirometry, a thorough examination including symptom history, and other tests

such as a chest x-ray, and labs. A spirometry can be done in a doctor’s office, the patient blows

into a mouthpiece which is connected to a spirometer or a laptop and this will determine how

much air a patient can inhale, exhale, or how fast they can exhale (AAFA, 2021). If the results

show a decreased lung function the patient is given a bronchodilator and if lung function

improves this helps to make an asthma diagnosis (AAFA, 2021).

Factors that need to be considered when selecting the best medication to use includes the

step-up approach for intermittent, mild, moderate, and severe asthma, as the goal of treatment is

to prevent symptoms by reducing airway inflammation and hyperactivity (Falk et al., 2016).


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Treatment would be chosen on the severity of the asthma using the step-up approach through

GINA guidelines. Previous guidelines were recommendations that patients with mild asthma

should be treated with an as-needed SABA (short acting beta agonist), however in 2019 GINA

changed its guidelines to include ICS-containing (inhaled corticosteroid) controller treatment

with a SABA (GINA 2019). This guideline change was done because a SABA-only treatment is

associated with an increased risk of exacerbations and lower lung functioning in patients and

severe exacerbations can lead to an increased risk of death (GINA, 2019). To prevent asthma

exacerbations and to help to control symptoms GINA now recommends that every adult and

adolescent with asthma should receive ICS-containing controller medication to reduce their risks

of exacerbations and this is to include patients with infrequent symptoms (GINA, 2019).

Treatment options will be beta agonist and corticosteroid combination, Advair Diskus

(fluticasone propionate/salmeterol xinafoate) or generic, 50mcg/500mcg, inhale 1 actuation

every 12 hours for prevention of asthma exacerbations (Micromedex, 2021). For a rescue inhaler

treatment options would be a Ventolin HFA (albuterol sulfate inhalation aerosol) 90mcg 2

puffs/oral inhalations every 4 to 6 hours as needed for shortness of breath (Micromedex, 2021).

For patients with compliance issues or concerns Breo Ellipta (fluticasone furoate 100mcg

and vilanterol 25mcg inhalation powder) inhale one actuation once daily (Micromedex, 2021).

Breo is a combination of ICS and a LABA (long-acting beta2-adrenergic agonist) medication

(Micromedex, 2021). Breo can be used as a once daily option for compliance in concerns with

patients who will not take an inhaler twice a day. Every patient diagnosed with asthma should be

prescribed a rescue inhaler (Falk et al., 2016).

There is a wide variety of treatment options for asthma, some of these medications can

also be included are medications such as anticholinergics such as Spiriva Respimate and




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