NSG 6005 Advanced Pharmacology FL02 Week 4 Completed A

NSG 6005 Advanced Pharmacology FL02 Week 4 Johnathan is experiencing asthma exacerbation based on his diagnosis. Intermittent asthma is the least severe type of asthma. This type of asthma symptoms typically come and go. Asthma exacerbations consist of acute or subacute episodes of progressively worsening shortness of breath, coughing, wheezing, and chest tightness or any combination thereof. These episodes differ from poor asthma control in that diurnal variability in airflow, a key marker of poor asthma control, might not change during an exacerbation (Woo, & Robinson, 2015). Intermittent inhaled corticosteroid therapy can be used for Johnathan's exacerbation of his asthma. Corticosteroid reduces the risk of asthma exacerbations in children and adults with mild persistent asthma. Intermittent use appears to be safe in these patients. The effects of corticosteroids are produced by suppressing the production of chemotactic mediators and adhesion molecules and by inhibiting the survival of these inflammatory cells in the airways (Hossny, Rosario, Lee, Singh, El-Ghoneimy, SOH, & Le Souef, 2016). Jonathan's mother would need to be educated about Johnathan's asthma. Johnathan's mom would have to understand the aspects of asthma. Asthma can usually be treated successfully. This requires being well informed about the disease and is active in managing it. Johnathan's mother would have to informed of the different symptoms of asthma which include wheezing, coughing, chest tightness, and shortness of breath. These symptoms tend to come and go which requires observing and attention (Woo, & Robinson, 2015). FEV1 is one of the most common indices used to assess airway obstruction. The FEV1 is a home-based machine that could be used as part of the home monitoring program for asthma. It is automatically calculated during spirometry or pulmonary function testing which is calculated using a spirometer. FEV1 is the maximal amount of air that one can forcefully exhale in one second. It is then converted to a percentage of normal. The forced expiratory volume is used to diagnose or monitor the asthma control. Some symptoms such as wheezing, chest tightness, cough and shortness of breath may trigger the use of the machine (Ranu, Wilde, & Madden, 2011). Asthma can be very mild and need little or no medical treatment which can be classified as severe and life-threatening. Symptoms related to asthma include wheezing or whistling when breathing, coughing, swollen airways and development of mucus in the airways. There are four types from mild to severe, these include: Mild intermittent asthma - which is the least severe type of asthma. With this type of asthma, one may experience episodes twice a week or less with nighttime symptoms occurring at most twice a month. Mild persistent asthma generally has asthma symptoms more than twice a week, but not more than once a day. The nighttime symptoms associated with this type of asthma may occur more than twice a month. Moderate persistent asthma is classified as moderate persistent if symptoms occur daily. The flare-ups occur and usually last several days. The symptoms may include coughing and wheezing may disrupt the child's normal activities and make it difficult to sleep. Severe persistent asthma symptoms occur daily and often. They also frequently curtail the child’s activities or disrupt his sleep. Lung function is less than 60% of the normal level without treatment (Woo, & Robinson, 2015). As the NP, I would recommend that Johnathan's mom be aware of asthma triggers that would cause a flare-up such as allergens which include dust, pollen, mold, and dogs. Triggers such as respiratory infections, irritants such as tobacco smoke, chemicals. He should be careful of physical activity, especially when the air that is breathed is cold, certain medicines, known as beta blockers and emotional stress. Additionally, a small number of patients will develop asthma symptoms after exposure to aspirin or other nonsteroidal anti-inflammatory medications, like ibuprofen or naproxen (Woo, & Robinson, 2015). The plan of care action I would take is to ensure that the patient is receiving proper amounts of oxygen. Ask about triggers to make sure the patient is not experiencing any. I would need to check to auscultate lung sounds, to see if wheezy they may need a breathing treatment. Have the patient perform a peak flow meter because the peak flow meters tell how much air that patient can exhale. The smaller the number the less amount of air they are moving as well as breathing treatments and medication therapy. Additionally, since the child has been working very hard to breathe for a long period of time and is getting worse it would be best to prepare with an airway cart (Woo, & Robinson, 2015). Reference Hossny, E., Rosario, N., Lee, B. W., Singh, M., El-Ghoneimy, D., SOH, J. Y., & Le Souef, P. (2016). The use of inhaled corticosteroids in pediatric asthma: update. The World Allergy Organization Journal, 9, 26. Ranu, H., Wilde, M., & Madden, B. (2011). Pulmonary Function Tests. The Ulster Medical Journal, 80(2), 84–90. Woo, T. & Robinson, M. (2015). Pharmacotherapeutics for Advanced Practice Nurse Prescribers with Davis Plus eResourses, 4th ed. F.A. Davis Company. ISBN: 8273