Sample Answer for NUR-635 Topic 9 DQ 1 Included After Question
Beth is a 13-year-old female who is experiencing shortness of breath. She is currently prescribed an albuterol inhaler. Upon examination, she experiences persistent symptoms daily, and sometimes they cause nighttime awakenings.
She finds herself using the inhaler once daily. During PE class she finds her asthma has sometimes limited her ability to participate. Use the guidelines and relevant literature in your topic Resources to discuss the following:
Briefly explain the pathophysiology associated with asthma.
How does an albuterol inhaler help treat asthma? What are the key adverse effects associated with the medication?
How would you classify Beth’s asthma using the National Heart, Lung, and Blood Institute (NHLBI) Prevention Program? Explain your rationale.
Using the stepwise approach, you as a prescriber have decided to add an inhaled corticoid steroid (ICS) to the patient’s regimen. Explain how an ICS will help with the treatment of asthma. Which medication, dose, and frequency will you prescribe? What are the key adverse effects associated with the medication?
Three months later, Beth’s symptoms persist as Beth uses her albuterol inhaler daily while on the ICS. Based on the National Heart, Lung, and Blood Institute (NHLBI) Prevention Program, which medication, dose, and frequency will you prescribe? What are the key adverse effects associated with the medication?
Also, when reviewing Beth’s most recent BMP, you find that her potassium was 3.0mmol/L. In the past, her potassium has trended within normal limits. Explain a possible cause regarding the potassium shift as pertains to her medication regimen.
American Association of Colleges of Nursing Core Competencies for Professional Nursing Education
This assignment aligns to AACN Core Competencies 1.2, 2.2, 2.5. 4.2, 6.4, 9.2
A Sample Answer For the Assignment: NUR-635 Topic 9 DQ 1
Title: NUR-635 Topic 9 DQ 1
Briefly explain the pathophysiology associated with asthma.
Asthma is a chronic inflammatory disorder of the airways. Immune response to known allergens affect 50% of children and some adults with asthma. In the remaining children and most adults, the cause of inflammation is unknown, although, unidentified allergens are suspected (Rosenthal & Burchum, 2020).
How does an albuterol inhaler help treat asthma? What are the key adverse effects associated with the medication?
Albuterol belongs to the family of medicines known as adrenergic bronchodilators. Adrenergic bronchodilators are medicines that are breathed in through the mouth to open up the bronchial tubes (air passages) in the lungs. They relieve cough, wheezing, and trouble breathing by increasing the flow of air through the bronchial tubes (Mayo Clinic, 2023).
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, the provider may want to change the dose, or other precautions may be necessary. Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco ( Mayo Clinic, 2023).
How would you classify Beth’s asthma using the National Heart, Lung, and Blood Institute (NHLBI) Prevention Program? Explain your rationale.
According to the NHLBI prevention program, Beth’s asthma would be classified as moderate due to the fact she experiences shortness of breath daily, has some nighttime awakenings, has limits during physical activity and requires use of her inhaler once a day (NHLBI, 2007).
Using the stepwise approach, you as a prescriber have decided to add an inhaled corticoid steroid (ICS) to the patient’s regimen. Explain how an ICS will help with the treatment of asthma. Which medication, dose, and frequency will you prescribe? What are the key adverse effects associated with the medication?
Inhaled corticosteroids (ICS) are the most effective controllers of asthma. They suppress inflammation mainly by switching off multiple activated inflammatory genes through reversing histone acetylation via the recruitment of histone deacetylase 2 (HDAC2). Through suppression of airway inflammation ICS reduce airway hyperresponsiveness and control asthma symptoms. ICS are now first-line therapy for all patients with persistent asthma, controlling asthma symptoms and preventing exacerbations. Inhaled long-acting β2-agonists added to ICS further improve asthma control and are commonly given as combination inhalers, which improve compliance and control asthma at lower doses of corticosteroids (Barnes, 2010).
For Beth, I would prescribe Ciclesonide 50mcg, 2 puffs daily. I would monitor for common side effects which include, stuffy nose, sore throat, and headaches. Serious reactions include, hives, swelling of your face, lips, or tongue, difficulty breathing (GoodRx, 2023).
Three months later, Beth’s symptoms persist as Beth uses her albuterol inhaler daily while on the ICS. Based on the National Heart, Lung, and Blood Institute (NHLBI) Prevention Program, which medication, dose, and frequency will you prescribe? What are the key adverse effects associated with the medication?
For Beth’s symptoms, I would add a LABA. The medication I would prescribe would be, Salmeterol, DPI (50 µg/inhalation), 1 inhalation every 12 hours. This medication, more frequent use may be needed due to benefits persisting for shorter periods as duration of treatment increases (Rosenthal & Burchum, 2020).
Also, when reviewing Beth’s most recent BMP, you find that her potassium was 3.0mmol/L. In the past, her potassium has trended within normal limits. Explain a possible cause regarding the potassium shift as pertains to her medication regimen.
Short-acting beta agonists and long-acting beta agonists help people with asthma and chronic obstructive pulmonary disease (COPD) breathe better. But these medications like albuterol (Proair HFA, Ventolin) and salmeterol (Serevent diskus) also lower blood potassium levels by moving potassium into your cells (GoodRx, 2023).
References:
Alvesco (ciclesonide): Uses, side effects, dosage & reviews. GoodRx. (2023). https://www.goodrx.com/alvesco/what-is
Barnes, P. J. (2010). Inhaled corticosteroids. Pharmaceuticals, 3(3), 514–540. https://doi.org/10.3390/ph3030514
Mayo Foundation for Medical Education and Research. (2023, October 1). Albuterol (inhalation route) proper use. Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/albuterol-inhalation-route/proper-use/drg-20073536?p=1
Rosenthal, L. D., & Burchum, J. R. (2020). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants – e-book (2nd ed.). Elsevier Health Sciences.
