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NR 566 Week 2 Respiratory Treatments Discussion: Asthma (Original Post, Peer Responses)
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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7 de junio de 2022
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2021/2022
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Chamberlain College Of Nursing
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NR 566
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1
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).
This study source was downloaded by 100000847795904 from CourseHero.com on 06 -07-2022 11:17:14 GMT -05:00
https://www.coursehero.com/file/94942244/Asthma-Week-2-discussiondocx/
, 2
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
This study source was downloaded by 100000847795904 from CourseHero.com on 06 -07-2022 11:17:14 GMT -05:00
https://www.coursehero.com/file/94942244/Asthma-Week-2-discussiondocx/