Asthma and chronic obstructive pulmonary disease (COPD) are significant public health burdens. Currently, more than 25 million people in the United States have asthma (HealthyPeople.gov, 2019). As an advanced practice nurse, you will likely encounter patients who will present with respiratory disorders, including asthma or COPD. Understanding specific treatment protocols as well as the types of pharmacotherapeutics used to treat respiratory disorders is important to ensure the effective and safe delivery of advanced nursing practice.

This week, you will evaluate drug therapy plans for patients who present with asthma and analyze the stepwise approach to asthma treatment and management from a patient in your professional practice.

Reference: HealthyPeople.gov. (2019). Respiratory diseases. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/respiratory-diseases

Learning Objectives

Students will:

• Evaluate drug therapy plans for asthma
• Assess the impact of asthma treatments on patients
• Analyze the stepwise approach to asthma treatment and management

Learning Resources

Required Readings (click to expand/reduce) 

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Chapter 62, “Drugs for Asthma and Chronic Obstructive Pulmonary Disease” (pp. 557–579)
Chapter 63, “Drugs for Allergic Rhinitis, Cough, and Colds” (pp. 580–588)

Document: APA Presentation Template

Required Media (click to expand/reduce) 

Speed Pharmacology. (2020). Drugs for asthma and COPD (Made Easy) [Video]. https://www.youtube.com/watch?v=-DVZ9pl0rGY
Note: This media program is approximately 14 minutes.

Speed Pharmacology. (2017). Antihistamines (Made Easy) [Video]. https://www.youtube.com/watch?v=D5PHANcdA_E&t=25s
Note: This media program is approximately 10 minutes.

Optional Resources (click to expand/reduce) 

National Heart Lung and Blood Institute. (2007). Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma. Retrieved from http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm

This web resource presents guidelines for diagnosing and managing asthma and outlines treatment recommendations for specific age groups.
 

Assignment: Asthma and Stepwise Management

Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment, making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening ones. Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors.  

Photo Credit: Photo Library / Getty Images

One method that supports the clinical decision making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.

To Prepare

• Reflect on drugs used to treat asthmatic patients, including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients, including adults and children.
• Consider how you might apply the stepwise approach to address the health needs of a patient in your practice.
• Reflect on how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

By Day 7 of Week 3

Create a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following:

• Describe long-term control and quick relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient.
• Explain the stepwise approach to asthma treatment and management for your patient.
• Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.

11-year-old boy complains of wheezing and difficulty “getting enough air.” Notices it more when he is playing baseball and symptoms improve when exercise activity stops. He says that the symptoms are getting worse and the symptoms are even occurring at rest. Mother says the child is allergic to cat dander and his next-door neighbor in their apartment building recently began sheltering cats for the local humane society. Auscultation demonstrates wheezes on forced expiration throughout all lung fields. 

Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following:  Each bullet point should reflect a subject heading followed by subsequent content reflective of primary sources of reference as well as Standards of Care. 

• The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
• Any racial/ethnic variables that may impact physiological functioning.
• How these processes interact to affect the patient.

https://www-ncbi-nlm-nih-gov.ezp.waldenulibrary.org/pmc/articles/PMC4961993/

RUBRIC:

               Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following:

Explain both the cardiovascular and cardiopulmonary pathophysiologic processes of why the patient presents these symptoms.           Points:       Points Range:    28 (28%) – 30 (30%) The response accurately and thoroughly describes the patient symptoms.

The response includes accurate, clear, and detailed reasons, with explanation for both the cardiovascular and cardiopulmonary pathophysiologic processes supported by evidence and/or research, as appropriate, to support the explanation.    Feedback:           Points:       Points Range:    25 (25%) – 27 (27%) The response describes the patient symptoms.

The response includes accurate reasons, with explanation for both the cardiovascular and cardiopulmonary pathophysiologic processes supported by evidence and/or research, as appropriate, to support the explanation.    Feedback:           Points:       Points Range:    23 (23%) – 24 (24%) The response describes the patient symptoms in a manner that is vague or inaccurate.

The response includes reasons for the cardiovascular and/or cardiopulmonary pathophysiologic processes, with explanations that are vague or based on inappropriate evidence/research.    Feedback:           Points:       Points Range:    0 (0%) – 22 (22%) The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing.

The response does not include reasons for either the cardiovascular or cardiopulmonary pathophysiologic processes, or the explanations are vague or based on inappropriate or no evidence/research.    Feedback:     Explain how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.           Points:       Points Range:    28 (28%) – 30 (30%) The response includes an accurate, complete, detailed, and specific explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.    Feedback:           Points:       Points Range:    25 (25%) – 27 (27%) The response includes an accurate explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.    Feedback:           Points:       Points Range:    23 (23%) – 24 (24%) The response includes a vague or inaccurate explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.    Feedback:           Points:       Points Range:    0 (0%) – 22 (22%) The response includes a vague or inaccurate explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.    Feedback:     Explain any racial/ethnic variables that may impact physiological functioning.           Points:       Points Range:    23 (23%) – 25 (25%) The response includes an accurate, complete, detailed, and specific explanation of racial/ethnic variables that may impact physiological functioning supported by evidence and/or research, as appropriate, to support the explanation.    Feedback:           Points:       Points Range:    20 (20%) – 22 (22%) The response includes an accurate explanation of racial/ethnic variables that may impact physiological functioning supported by evidence and/or research, as appropriate, to support the explanation.    Feedback:           Points:       Points Range:    18 (18%) – 19 (19%) The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, and/or explanations based on inappropriate evidence/research.    Feedback:           Points:       Points Range:    0 (0%) – 17 (17%) The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, or the explanations are based on inappropriate or no evidence/research.    Feedback:     Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.           Points:       Points Range:    5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.    Feedback:           Points:       Points Range:    4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.     

Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.    Feedback:           Points:       Points Range:    3 (3%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.      

Purpose, introduction, and conclusion of the assignment are vague or off topic.    Feedback:           Points:       Points Range:    0 (0%) – 2 (2%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

No purpose statement, introduction, or conclusion were provided.    Feedback:     Written Expression and Formatting – English Writing Standards:
Correct grammar, mechanics, and proper punctuation           Points:       Points Range:    5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors.    Feedback:           Points:       Points Range:    4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors.    Feedback:           Points:       Points Range:    3 (3%) – 3 (3%) Contains several (3 or 4) grammar, spelling, and punctuation errors.    Feedback:           Points:       Points Range:    0 (0%) – 2 (2%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.    Feedback:     Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.           Points:       Points Range:    5 (5%) – 5 (5%) Uses correct APA format with no errors.    Feedback:           Points:       Points Range:    4 (4%) – 4 (4%) Contains a few (1 or 2) APA format errors.    Feedback:           Points:       Points Range:    3 (3%) – 3 (3%) Contains several (3 or 4) APA format errors.    Feedback:           Points:       Points Range:    0 (0%) – 2 (2%) Contains many (≥ 5) APA format errors.    Feedback:   Show DescriptionsShow Feedback

Develop a 1- to 2-page case study analysis, examing the patient symptoms presented in the case study. Be sure to address the following:

Explain both the cardiovascular and cardiopulmonary pathophysiologic processes of why the patient presents these symptoms.–

Levels of Achievement:Excellent28 (28%) – 30 (30%)The response accurately and thoroughly describes the patient symptoms.

The response includes accurate, clear, and detailed reasons, with explanation for both the cardiovascular and cardiopulmonary pathophysiologic processes supported by evidence and/or research, as appropriate, to support the explanation.Good25 (25%) – 27 (27%)The response describes the patient symptoms.

The response includes accurate reasons, with explanation for both the cardiovascular and cardiopulmonary pathophysiologic processes supported by evidence and/or research, as appropriate, to support the explanation.Fair23 (23%) – 24 (24%)The response describes the patient symptoms in a manner that is vague or inaccurate.

The response includes reasons for the cardiovascular and/or cardiopulmonary pathophysiologic processes, with explanations that are vague or based on inappropriate evidence/research.Poor0 (0%) – 22 (22%)The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing.

The response does not include reasons for either the cardiovascular or cardiopulmonary pathophysiologic processes, or the explanations are vague or based on inappropriate or no evidence/research.Feedback:

Explain how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.–

Levels of Achievement:Excellent28 (28%) – 30 (30%)The response includes an accurate, complete, detailed, and specific explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.Good25 (25%) – 27 (27%)The response includes an accurate explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.Fair23 (23%) – 24 (24%)The response includes a vague or inaccurate explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.Poor0 (0%) – 22 (22%)The response includes a vague or inaccurate explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.Feedback:

Explain any racial/ethnic variables that may impact physiological functioning.–

Levels of Achievement:Excellent23 (23%) – 25 (25%)The response includes an accurate, complete, detailed, and specific explanation of racial/ethnic variables that may impact physiological functioning supported by evidence and/or research, as appropriate, to support the explanation.Good20 (20%) – 22 (22%)The response includes an accurate explanation of racial/ethnic variables that may impact physiological functioning supported by evidence and/or research, as appropriate, to support the explanation.Fair18 (18%) – 19 (19%)The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, and/or explanations based on inappropriate evidence/research.Poor0 (0%) – 17 (17%)The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, or the explanations are based on inappropriate or no evidence/research.Feedback:

Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.–

Levels of Achievement:Excellent5 (5%) – 5 (5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.Good4 (4%) – 4 (4%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.     

Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.Fair3 (3%) – 3 (3%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.      

Purpose, introduction, and conclusion of the assignment are vague or off topic.Poor0 (0%) – 2 (2%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

No purpose statement, introduction, or conclusion were provided.Feedback:

Written Expression and Formatting – English Writing Standards:
Correct grammar, mechanics, and proper punctuation–

Levels of Achievement:Excellent5 (5%) – 5 (5%)Uses correct grammar, spelling, and punctuation with no errors.Good4 (4%) – 4 (4%)Contains a few (1 or 2) grammar, spelling, and punctuation errors.Fair3 (3%) – 3 (3%)Contains several (3 or 4) grammar, spelling, and punctuation errors.Poor0 (0%) – 2 (2%)Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.Feedback:

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.–

Levels of Achievement:Excellent5 (5%) – 5 (5%)Uses correct APA format with no errors.Good4 (4%) – 4 (4%)Contains a few (1 or 2) APA format errors.Fair3 (3%) – 3 (3%)Contains several (3 or 4) APA format errors.Poor0 (0%) – 2 (2%)Contains many (≥ 5) APA format errors.Feedback: Total Points: 100

Healthy People 2020 identifies objectives related to nutrition and its role in promoting health and reducing chronic disease risk. Choose one preventable chronic condition from the list (type 2 diabetes). As a nurse practitioner, how will you educate your patient about nutrition to help prevent your chosen chronic condition? Support your answer with evidence-based research. 

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Expectations

Initial Post:

• Length: A minimum of 250 words, not including references
• Citations: At least one high-level scholarly reference in APA from within the last 5 years
  

  Required Textbook and Readings

  Edelman, C. L., & Kudzma, E. C.. (2018). Health Promotion Throughout the Life Span, 9th edition. St. Louis, MO: Elsevier, Mosby. ISBN: 978-0-323-416733

 Required Assignment Topic

Note: You will use the same scenario you developed and same mHealth app you identified in Week 2.

Requirements and Guidelines

• Download the required Milestone 2 Template (Links to an external site.). Save it to your computer with the file name: Your Last Name NR361 Milestone 2.docx.
• Briefly state the patient scenario from the Milestone 1 assignment.
  • Include revisions, if required by Milestone 1 faculty feedback.
• Identify (3) teaching areas to improve patient outcomes.
  • Information to be taught to the patient should include information about the mHealth app, safety guidelines, and how to interpret and act on the information that is provided. Remember to cite the mHealth app when appropriate in the Teaching Area (See template).
  • Use bullet points
• Describe 3 ways you would determine and evaluate the success of the patient’s use of the mHealth app.
  • Use bullet points
  • mHealth app citation and reference in APA format.  See placement of these on the template.
• You are required to complete the form using the productivity tools required by Chamberlain University, which is Microsoft Office Word 2013 (or later version), or Windows and Office 2011 (or later version) for MAC. You must save the file in the “.docx” format. Do NOT save as Word Pad. A later version of the productivity tool includes Office 365, which is available to Chamberlain students for FREE by downloading from the student portal at http://my.chamberlain.edu  
• Carefully review the grading rubric criteria for Milestone 2 and type directly on your saved Milestone 2 Template.
• Use instructor feedback from Milestone 1 to improve your statements regarding the patient scenario in Milestone 2.

What obstacles must be overcome for effective decision making? What specific strategies can be used to promote a climate in which critical thinking is fostered? What are the risks in decision making?

Prepare assignment following the APA style guideline
Prepare your assignment using no less than 500 words
Site at least two more resources to complete assignment