Asthma Management and Treatment Nursing Essay Assignment Paper

The Management and Treatment of Asthma: Asthma is a serious public health problem for children and adolescents in the United States. In 2011, approximately one out of 10 school-aged children had asthma. Because of this chronic illness, students miss 10.5 million school days each year (United States Environmental Protection Agency, 2011). There are several barriers in the management and treatment of asthma. Barriers can be created by the parents and guardians or by their children experiencing asthma. Asthma Management and Treatment Nursing Essay Assignment Paper. Parents and guardians may experience decreased motivation for changing behavior in their children (Bender, 2002). For example, 12-year-old William does not clean his room weekly to get rid of dust mites, which is one of his asthma triggers. After repeated attempts to get him to comply, his parents become less motivated to try to change that behavior. In response to the multiple barriers to effective asthma management and treatment, children and adolescents may find different ways to cope with their illness (Ryan-Wenger & Walsh, 1994). Asthma Management and Treatment Nursing Essay Assignment Paper

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For this Assignment, imagine you are a health psychology professional and you need to develop a brochure for students with asthma. Consider how you might describe asthma to children and adolescents. Then describe the barriers created by children and adolescents and the potential impact to them. Review the media in this week’s Learning Resources. Please note that you will only view media featuring adolescents because of ethical and legal considerations regarding the taping of younger children. Asthma Management and Treatment Nursing Essay Assignment Paper

Submit your Assignment by Day 7. This assignment may be used as the foundation for your comprehensive program due in Week 10. Please review the Week 10 Assignment for details. Please use your creativity while developing your Assignment. You may use the templates provided for your Assignment found in the Course Information area or you may create your own.

The Assignment (1 brochure)

Create a brochure that could be used in a hospital, clinic, or a school counselor’s office.

Include the following information within your brochure:

Define asthma in children and adolescents.

Describe three potential barriers to controlling asthma for children and adolescents.

Explain the potential impacts of asthma to the daily functioning of children and adolescents.

Explain the differences in coping strategies between children and adolescents with asthma.

Use appropriate APA references at the bottom of your brochure.

Asthma Management and Treatment Nursing Essay Assignment Paper

Diagnosis

Physical exam

To rule out other possible conditions — such as a respiratory infection or chronic obstructive pulmonary disease (COPD) — your doctor will do a physical exam and ask you questions about your signs and symptoms and about any other health problems.

Tests to measure lung function

You may also be given lung (pulmonary) function tests to determine how much air moves in and out as you breathe. These tests may include:

Spirometry. This test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out.
Peak flow. A peak flow meter is a simple device that measures how hard you can breathe out. Lower than usual peak flow readings are a sign your lungs may not be working as well and that your asthma may be getting worse. Your doctor will give you instructions on how to track and deal with low peak flow readings. Asthma Management and Treatment Nursing Essay Assignment Paper

Lung function tests often are done before and after taking a medication called a bronchodilator (brong-koh-DIE-lay-tur), such as albuterol, to open your airways. If your lung function improves with use of a bronchodilator, it’s likely you have asthma.

Additional tests

Other tests to diagnose asthma include:

Methacholine challenge. Methacholine is a known asthma trigger that, when inhaled, will cause mild constriction of your airways. If you react to the methacholine, you likely have asthma. This test may be used even if your initial lung function test is normal.
Nitric oxide test. This test, though not widely available, measures the amount of the gas, nitric oxide, that you have in your breath. When your airways are inflamed — a sign of asthma — you may have higher than normal nitric oxide levels.
Imaging tests. A chest X-ray and high-resolution computerized tomography (CT) scan of your lungs and nose cavities (sinuses) can identify any structural abnormalities or diseases (such as infection) that can cause or aggravate breathing problems.
Allergy testing. This can be performed by a skin test or blood test. Allergy tests can identify allergy to pets, dust, mold and pollen. If important allergy triggers are identified, this can lead to a recommendation for allergen immunotherapy. Asthma Management and Treatment Nursing Essay Assignment Paper
Sputum eosinophils. This test looks for certain white blood cells (eosinophils) in the mixture of saliva and mucus (sputum) you discharge during coughing. Eosinophils are present when symptoms develop and become visible when stained with a rose-colored dye (eosin).
Provocative testing for exercise and cold-induced asthma. In these tests, your doctor measures your airway obstruction before and after you perform vigorous physical activity or take several breaths of cold air.

How asthma is classified

To classify your asthma severity, your doctor considers your answers to questions about symptoms (such as how often you have asthma attacks and how bad they are), along with the results of your physical exam and diagnostic tests.

Determining your asthma severity helps your doctor choose the best treatment. Asthma severity often changes over time, requiring treatment adjustments. Asthma Management and Treatment Nursing Essay Assignment Paper

Asthma is classified into four general categories:

Asthma classification	Signs and symptoms
Mild intermittent	Mild symptoms up to two days a week and up to two nights a month
Mild persistent	Symptoms more than twice a week, but no more than once in a single day
Moderate persistent	Symptoms once a day and more than one night a week
Severe persistent	Symptoms throughout the day on most days and frequently at night

Treatment

Prevention and long-term control are key in stopping asthma attacks before they start. Treatment usually involves learning to recognize your triggers, taking steps to avoid them and tracking your breathing to make sure your daily asthma medications are keeping symptoms under control. In case of an asthma flare-up, you may need to use a quick-relief inhaler, such as albuterol. Asthma Management and Treatment Nursing Essay Assignment Paper

Medications

The right medications for you depend on a number of things — your age, symptoms, asthma triggers and what works best to keep your asthma under control.

Preventive, long-term control medications reduce the inflammation in your airways that leads to symptoms. Quick-relief inhalers (bronchodilators) quickly open swollen airways that are limiting breathing. In some cases, allergy medications are necessary.

Long-term asthma control medications, generally taken daily, are the cornerstone of asthma treatment. These medications keep asthma under control on a day-to-day basis and make it less likely you’ll have an asthma attack. Types of long-term control medications include:

Inhaled corticosteroids. These anti-inflammatory drugs include fluticasone (Flonase, Flovent HFA), budesonide (Pulmicort Flexhaler, Rhinocort), flunisolide (Aerospan HFA), ciclesonide (Alvesco, Omnaris, Zetonna), beclomethasone (Qnasl, Qvar), mometasone (Asmanex) and fluticasone furoate (Arnuity Ellipta). Asthma Management and Treatment Nursing Essay Assignment Paper
You may need to use these medications for several days to weeks before they reach their maximum benefit. Unlike oral corticosteroids, these corticosteroid medications have a relatively low risk of side effects and are generally safe for long-term use.
Leukotriene modifiers. These oral medications — including montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo) — help relieve asthma symptoms for up to 24 hours.In rare cases, these medications have been linked to psychological reactions, such as agitation, aggression, hallucinations, depression and suicidal thinking. Seek medical advice right away for any unusual reaction.
Long-acting beta agonists. These inhaled medications, which include salmeterol (Serevent) and formoterol (Foradil, Perforomist), open the airways.Some research shows that they may increase the risk of a severe asthma attack, so take them only in combination with an inhaled corticosteroid. And because these drugs can mask asthma deterioration, don’t use them for an acute asthma attack. Asthma Management and Treatment Nursing Essay Assignment Paper
Combination inhalers. These medications — such as fluticasone-salmeterol (Advair Diskus), budesonide-formoterol (Symbicort) and formoterol-mometasone (Dulera) — contain a long-acting beta agonist along with a corticosteroid. Because these combination inhalers contain long-acting beta agonists, they may increase your risk of having a severe asthma attack.
Theophylline. Theophylline (Theo-24, Elixophyllin, others) is a daily pill that helps keep the airways open (bronchodilator) by relaxing the muscles around the airways. It’s not used as often now as in past years.

Quick-relief (rescue) medications are used as needed for rapid, short-term symptom relief during an asthma attack — or before exercise if your doctor recommends it. Types of quick-relief medications include:

Short-acting beta agonists. These inhaled, quick-relief bronchodilators act within minutes to rapidly ease symptoms during an asthma attack. They include albuterol (ProAir HFA, Ventolin HFA, others) and levalbuterol (Xopenex). Asthma Management and Treatment Nursing Essay Assignment Paper
Short-acting beta agonists can be taken using a portable, hand-held inhaler or a nebulizer — a machine that converts asthma medications to a fine mist — so that they can be inhaled through a face mask or a mouthpiece.
Ipratropium (Atrovent). Like other bronchodilators, ipratropium acts quickly to immediately relax your airways, making it easier to breathe. Ipratropium is mostly used for emphysema and chronic bronchitis, but it’s sometimes used to treat asthma attacks.
Oral and intravenous corticosteroids. These medications — which include prednisone and methylprednisolone — relieve airway inflammation caused by severe asthma. They can cause serious side effects when used long term, so they’re used only on a short-term basis to treat severe asthma symptoms.

If you have an asthma flare-up, a quick-relief inhaler can ease your symptoms right away. But if your long-term control medications are working properly, you shouldn’t need to use your quick-relief inhaler very often. Asthma Management and Treatment Nursing Essay Assignment Paper

Keep a record of how many puffs you use each week. If you need to use your quick-relief inhaler more often than your doctor recommends, see your doctor. You probably need to adjust your long-term control medication.

Allergy medications may help if your asthma is triggered or worsened by allergies. These include:

Allergy shots (immunotherapy). Over time, allergy shots gradually reduce your immune system reaction to specific allergens. You generally receive shots once a week for a few months, then once a month for a period of three to five years.
Omalizumab (Xolair). This medication, given as an injection every two to four weeks, is specifically for people who have allergies and severe asthma. It acts by altering the immune system. Asthma Management and Treatment Nursing Essay Assignment Paper

Bronchial thermoplasty

This treatment — which isn’t widely available nor right for everyone — is used for severe asthma that doesn’t improve with inhaled corticosteroids or other long-term asthma medications.

Generally, over the span of three outpatient visits, bronchial thermoplasty heats the insides of the airways in the lungs with an electrode, reducing the smooth muscle inside the airways. This limits the ability of the airways to tighten, making breathing easier and possibly reducing asthma attacks.

Treat by severity for better control: A stepwise approach

Your treatment should be flexible and based on changes in your symptoms, which should be assessed thoroughly each time you see your doctor. Then your doctor can adjust your treatment accordingly.

For example, if your asthma is well-controlled, your doctor may prescribe less medicine. If your asthma isn’t well-controlled or is getting worse, your doctor may increase your medication and recommend more-frequent visits.

Asthma action plan

Work with your doctor to create an asthma action plan that outlines in writing when to take certain medications or when to increase or decrease the dose of your medications based on your symptoms. Also include a list of your triggers and the steps you need to take to avoid them. Asthma Management and Treatment Nursing Essay Assignment Paper

Your doctor may also recommend tracking your asthma symptoms or using a peak flow meter on a regular basis to monitor how well your treatment is controlling your asthma.

Treatment and Management

Signs that your asthma is under control are:¹

You are free from troublesome symptoms during the day and night.
You can participate fully in any activity you choose.
You do not need to miss school or work because of asthma symptoms.
You rarely need to visit urgent care or the emergency department for asthma.
You have the best lung function possible.
Your medications control your asthma with as few side effects as possible.
You are satisfied with your asthma care. Asthma Management and Treatment Nursing Essay Assignment Paper

Four fundamental steps for achieving these goals are:¹

Using long-term control medications.
Avoiding asthma triggers.
Treating co-existing medical conditions.
Monitoring changes in your symptoms or lung function.

Asthma Management and Treatment Nursing Essay Assignment Paper

When symptoms flare up, a written Asthma Action Plan can help you begin treatment at home and figure out when to get additional medical help.

What asthma medications are used for long-term asthma control?

For people with persistent asthma, using asthma control medications daily is key to achieving the treatment goals. Long-term control medications include inhaled corticosteroids, inhaled long-acting beta agonists, leukotriene modifiers, theophylline, omalizumab, and cromolyn.¹

The most frequently used asthma control medications reduce inflammation in your airways.¹ When the airways are less inflamed, they become less sensitive (“hyperresponsive”). This reduces your risk of having an asthma attack.^{1 Asthma Management and Treatment Nursing Essay Assignment Paper}

How can I avoid asthma triggers?

Knowing what triggers your asthma is a necessary first step. You and your provider can work together to identify your triggers. Common triggers include pet dander, dust-mites, cockroaches, pollen, mold, and viruses. Exercise, cold air, and pollution can also trigger symptoms. It can be helpful to think about which triggers you are regularly exposed to and when your symptoms are worst. Allergy testing can confirm specific allergies. This can help you to focus on the most important things to avoid. Certain triggers are unavoidable, but you can be prepared for times when additional treatments may be needed.¹

Asthma Management and Treatment Nursing Essay Assignment Paper

How do I monitor changes in my asthma?

You can monitor your asthma based on symptoms or using a peak flow meter. Both methods can work well.¹ The best choice depends on your preferences and type of asthma. Symptom-based monitoring may be better for children. Peak flow monitoring may be better for people with severe asthma, a history of sudden attacks, or difficulty noticing worsening symptoms. Monitoring your asthma helps you to notice the start of an asthma attack early. By starting treatment right away, you may be able to avoid having a severe asthma attack.

How are asthma attacks treated?

Follow your written Asthma Action Plan in the event of an asthma flare-up. Your plan should describe who and when to call based on your peak expiratory flow measurements and the type of symptoms you are having. In general, treatment begins at home.¹ You will be instructed on how to take your rescue inhaler. The next steps depend on how your symptoms respond to your rescue medication. Asthma Management and Treatment Nursing Essay Assignment Paper