What are the appropriate pharmacological therapies to be prescribed for Johnathan?
Johnathan’s asthma severity has reached a mild persistent stage. The stage is evident from the wheezing that has persisted for 24 hours and a tight cough after every one or two minutes. It is, therefore, vital to put Jonathan on the stepwise approach method of asthma management to enable the management of his symptoms with the least possible dosage. The mild-persistent stage falls under step 2 on the stepwise approach scale. Appropriate therapy for level two is a low-dose inhaled corticosteroid such as ciclesonide or cromolyn or a leukotriene receptor antagonist (Wong, Farne, & Jackson, 2016). Theophylline is also an option.
What information is necessary to provide to Johnathan and his mother regarding asthma exacerbation?
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They should be aware that exacerbations require quick response and early treatment for effective management. The management should include having an asthma action plan at home and identifying early symptoms. They should also identify environmental triggers and keep medical contacts in case of emergencies.
What is an appropriate clinical assessment tool to be used with Johnathan?
At age seven, Johnathan is under the Childhood Asthma Control Test (C-ACT) tool. The C-ACT toll covers children between four to eleven years (Quirt et al., 2018). The tool is not only validated but also easy to use.
What are the classifications of asthma?
In the stepwise approach management, asthma is classified under six stages, depending on the severity of symptoms. The classes are intermittent, mild-persistent, moderate-persistent, and severe-persistent (Wong, Farne, & Jackson, 2016). Dosage follows the six classes of asthma.
How would you, as the NP, address his mother's concern regarding providing an inhaler at school?
As a nursing practitioner, my first line of address would be to issue an official healthcare communication addressed to school management and teachers. The conversation will seek cooperation and assistance from school authorities in ensuring Johnathan's symptoms are managed while at school. Second, I will address healthcare education gaps to teachers and students. The educational sessions will cover possible triggers and actions during an asthma attack.
What is an appropriate plan of care for Johnathan?
It is an appropriate plan to put Johnathan on the stepwise approach. Due to the persistent character of his symptoms, Johnathan's plan will start at step 2 and be monitored to ensure that the minimum possible dose is prescribed to manage his symptoms. If his symptoms will persist while on step 2 dosage, Johnathan would be moved to step 3 until his conditions stabilize. After stabilization, he will be stepped down to a smaller dosage. Identifying and eliminating his triggers would also be beneficial.
References
Quirt, J., Hildebrand, K. J., Mazza, J., Noya, F., & Kim, H. (2018). Asthma. Allergy, Asthma & Clinical Immunology , 14 (S2). http://doi.10.1186/s13223-018-0279-0
Wong, E. H., Farne, H. A., & Jackson, D. J. (2016). Asthma: Diagnosis and management in adults. Medicine , 44 (5), 287-296. http://doi.10.1016/j.mpmed.2016.02.021
