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NR 566 Week 2 Case Study
Asthma
Subjective findings of Asthma
Shortness of breath
Chest tightness
Fatigue
Objective findings of Asthma
• Wheezing
• Dyspnea
• Cough
How is asthma confirmed
A through medical history is performed which includes investigating any medical conditions,
history of allergies, environmental exposure to allergens, tobacco use, and also explore family
history(Gobal Initiative for Asthma, 2020). A complete physical examination is done which
focuses on checking lungs, and sinuses, assessing ears, nose, and throat.
To confirm diagnosis, a lung function test is done to measure how the lungs are working. Adults
with characteristic symptoms of asthma has an increase or decrease in forced expiratory volume
in one second (FEV1) (Gobal Initiative for Asthma, 2020) Blood tests are also done to check for
white blood cells that are responsible for inflammation. In addition, chest X-ray is also done to
detect any hyperinflation of the alveoli of the lungs (American Lung Association, 2020).
What factors do you need to consider in selecting the best medication for the patient with the
condition?
The long-term treatment goals of asthma are symptom control and risk reduction. Factors that
needs to be considered includes the severity of asthma symptoms, which can range from mild to
severe. A step approach is used for treatment depending on the severity of symptom (Global
Initiative for Asthma, 2020). The type of population being treated also should be taken into
consideration, especially elderly and those with pre-existing conditions.
List 3 medication treatment options.
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According to Global Initiative for Asthma, (2020), the following mediations can be used
outpatient:
• Short acting beta agonist – Albuterol Inhaler
• Long acting beta agonist- Salmeterol inhaler
• Inhaled corticosteroid- Budesonide
Albuterol
Mechanism of action
According to Micromedex (2020), albuterol is a beta-adrenergic agonist that selectively acts on
the beta (2)-adrenergic receptors of intracellular adenyl cyclase. Its action increases cyclic AMP
levels resulting in bronchial smooth muscle relaxation and prevents the release of immediate
hypersensitivity mediators from mast cells (Micromedex, 2020).
Adverse Reactions
• Tachycardia
• Feeling nervous
• Tremor
Teaching points
• Educate patient about the side effects including palpitations, chest pain, tremors,
headache, dizziness, or nervousness
• Advise patient on proper inhalation technique when using inhaler
• Tell patient to report symptoms of paradoxical bronchospasm (Micromedex, 2020).
Salmeterol
Mechanism of action
Salmeterol is a long-acting beta-2-adrenergic agonist. It stimulates adenyl cyclase causing an
increased intracellular cyclic AMP level which in turn triggers bronchial smooth muscles
relaxation (Micromedex, 2020). The release of mediators for immediate hypersensitivity is also
inhibited.
Adverse Reactions
• Musculoskeletal pain
• Headache
• Prolonged QT interval
Teaching points
• Advise patient that the drug is not indicated for acute asthma attacks.
NR 566 Week 2 Case Study
Asthma
Subjective findings of Asthma
Shortness of breath
Chest tightness
Fatigue
Objective findings of Asthma
• Wheezing
• Dyspnea
• Cough
How is asthma confirmed
A through medical history is performed which includes investigating any medical conditions,
history of allergies, environmental exposure to allergens, tobacco use, and also explore family
history(Gobal Initiative for Asthma, 2020). A complete physical examination is done which
focuses on checking lungs, and sinuses, assessing ears, nose, and throat.
To confirm diagnosis, a lung function test is done to measure how the lungs are working. Adults
with characteristic symptoms of asthma has an increase or decrease in forced expiratory volume
in one second (FEV1) (Gobal Initiative for Asthma, 2020) Blood tests are also done to check for
white blood cells that are responsible for inflammation. In addition, chest X-ray is also done to
detect any hyperinflation of the alveoli of the lungs (American Lung Association, 2020).
What factors do you need to consider in selecting the best medication for the patient with the
condition?
The long-term treatment goals of asthma are symptom control and risk reduction. Factors that
needs to be considered includes the severity of asthma symptoms, which can range from mild to
severe. A step approach is used for treatment depending on the severity of symptom (Global
Initiative for Asthma, 2020). The type of population being treated also should be taken into
consideration, especially elderly and those with pre-existing conditions.
List 3 medication treatment options.
, 2
According to Global Initiative for Asthma, (2020), the following mediations can be used
outpatient:
• Short acting beta agonist – Albuterol Inhaler
• Long acting beta agonist- Salmeterol inhaler
• Inhaled corticosteroid- Budesonide
Albuterol
Mechanism of action
According to Micromedex (2020), albuterol is a beta-adrenergic agonist that selectively acts on
the beta (2)-adrenergic receptors of intracellular adenyl cyclase. Its action increases cyclic AMP
levels resulting in bronchial smooth muscle relaxation and prevents the release of immediate
hypersensitivity mediators from mast cells (Micromedex, 2020).
Adverse Reactions
• Tachycardia
• Feeling nervous
• Tremor
Teaching points
• Educate patient about the side effects including palpitations, chest pain, tremors,
headache, dizziness, or nervousness
• Advise patient on proper inhalation technique when using inhaler
• Tell patient to report symptoms of paradoxical bronchospasm (Micromedex, 2020).
Salmeterol
Mechanism of action
Salmeterol is a long-acting beta-2-adrenergic agonist. It stimulates adenyl cyclase causing an
increased intracellular cyclic AMP level which in turn triggers bronchial smooth muscles
relaxation (Micromedex, 2020). The release of mediators for immediate hypersensitivity is also
inhibited.
Adverse Reactions
• Musculoskeletal pain
• Headache
• Prolonged QT interval
Teaching points
• Advise patient that the drug is not indicated for acute asthma attacks.
