What is the appropriate pharmacological therapy to be prescribed for Johnathan
According to this case study, albuterol had been used in managing Johnathan’s condition. The drug had been recommended for the management of patients with asthma exacerbation because if its ability to relieve symptoms much faster than other drugs (Jones et al., 2016). As such albuterol must be included in the pharmacological therapies despite its failure to generate the desired outcomes in symptoms relief. For long term control therapy, corticosteroids need to be administered which will be crucial in the prevention of subsequent asthma incidences and inflammation reduction. Another drugs that would ensure appropriate management of the condition is oral dexamethasone 10 mg X2 which may be utilized as albuterol supplement.
What information is necessary to provide to Johnathan and his mother regarding asthma exacerbation?
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Regarding asthma, Johnathan and his mother need to be informed on how to recognize asthma triggers and should be made to understand various nonpharmacological asthma exacerbation prevention measures. As per Jones et al. (2016), one of the most common asthma’s exacerbating factors is viral respiratory infections. In this particular case, Johnathan’s condition began 3 days ago but not treatment was sought. This means Johnathan and his mother had proper awareness of asthma exacerbating factors. They should, therefore, be provided with adequate information concerning the various asthma triggers like dust mites and pollen. In order to manage this condition more effectively, it is crucial that the causative allergen is identified and avoided (Brown et al., 2017). For instance, hand-washing is a preventive measure for cold development. It is therefore important that the mother ensures that a hygienic environment and his hands as this will help in the prevention of viral-associated asthma exacerbations. They need to understand that the condition is dangerous and can be fatal if appropriate medical intervention is not sorted promptly.
What is an appropriate clinical assessment tool to be used with Johnathan?
Childhood Asthma Control Test is the most appropriate tool employed for Johnathan’s condition. The tool is deemed appropriate for children between 4 and 11 years (Woo & Robinson, 2015). In addition to being utilized in interviewing the child in the assessment of asthma, it is used to obtain asthma control dung the past 4 weeks by engaging the caregiver. It provides 7 questions of which 4 are answered by the child while the remaining 3 are answered by the caregiver. It also inquires about both nighttime and daytime symptoms. In this particular scenario, the tool is helpful to the healthcare provider in understanding the onset of the condition, the interventions sort as well as any available and effective therapy.
What are the classification of asthma?
Asthma can be classified based on its severity and the 4 main classes are intermittent asthma (coughing and wheezing is experienced less than twice weekly), mild persistent asthma (symptoms experienced 3-6 times weekly), moderate persistent (symptoms experienced daily), and severe persistent asthma (with continual symptoms) (Sekiya et al., 2016). In this scenario, Johnathan appears to suffer from intermittent asthma and in order to halt its progression, proper treatment is a must.
How would you as the NP address his mother’s concern regarding providing an inhaler at school?
Due to the unpredictable nature of asthmatic attacks, no one is sure of when the next attack will take place. As a result, the mother’s concern is a genuine and valid one. Therefore, I would recommend that she ensures that Johnathan has proper access to the inhaler because it is an effective way of managing the condition’s symptoms. Additionally, inadequate access to the inhaler may lead to longer-lasting symptoms that may bring about emergencies (Sekiya et al., 2016). Because of this, Johnathan’s mother has to request that Johnathan’s condition is monitored by the school nurse while he is at school as this collaboration will ensure the improvement of the condition’s management.
What is an appropriate plan of care for Johnathan?
The appropriate plan for Johnathan’s condition will include nonpharmacological management in addition to pharmacological therapy. The recommended medication includes short-acting beta-agonists which will be taken care of by the continued use of albuterol (Woo and Robinson, 2015). Corticosteroids will be given for proper symptom control (Jones et al., 2016). He should also take part in well-paced and less strenuous exercises. This kind of exercises allows time for rest while maintaining his body at an optimal state. Mild exercise also prevents exercise-induced asthma. Johnathan needs to take a well-balanced diet with a lot of vegetables and fruits which will enhance body immunity. In order to prevent further viral respiratory infection which is an exacerbation factor for asthma symptoms, he must prioritize hygiene through hand washing. This will aid in the prevention of viral infections.
References
Brown, D., Edwards, H., Seaton, L., & Buckley, T. (2017). Lewis's MedicalSurgical Nursing: Assessment and Management of Clinical Problems. Elsevier Health Sciences.
Jones, P. B., Fleming, G. M., Otillio, J. K., Asokan, I., & Arnold, D. H. (2016). Pediatric acute asthma exacerbations: Evaluation and management from the emergency department to the intensive care unit. Journal of Asthma, 53(6), 607617.doi:
Sekiya, K., Nakatani, E., Fukutomi, Y., Kaneda, H., Iikura, M., Yoshida, M., ... & Sugino, Y. (2016). Severe or life ‐ threatening asthma exacerbation: Patient heterogeneity identified by cluster analysis. Clinical & Experimental Allergy, 46(8), 10431055. https://doi.org/10.1111/cea.12738
Woo T. M., & Robinson, M. V. (2015). Pharmacotherapeutics for advanced practice nurse prescribers. Philadelphia, PA: FA Davis.
