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Posted: September 15th, 2023

A Stepwise Approach to Managing Asthma

Management of Acute Loss of Asthma
Control: The Yellow Zone
Karen Rance, DNP, CPNP, AE-C
Nurse practitioners (NPs) are at the frontline of treating asthma patients in primary,
specialty, and acute care and work closely with those patients to optimize their
outcome. The NP’s care of a patient with asthma includes both preventive
management and acute treatment. Overcoming the challenges of maintaining longterm asthma control and addressing episodes of loss of acute control require an
individualized approach to patient care. In view of the importance of quickly and
effectively treating any acute loss of control to prevent further sequelae, this
investigation addresses related management options and offer evidence-based
treatment considerations for NPs. 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.

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.

The Assignment

Create a 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.


For your Assignment this week, you are creating a staff development presentation regarding the stepwise management of asthma. Of note, grading is exclusively based on the content of the slides (do not include speaker notes). To achieve and maintain control of asthma, a stepwise approach to therapy is recommended, in which the dose and number of medications and frequency of administration are increased as necessary and decreased when possible. As this is a pharmacology course, it is important for you to identify specific medications for each of the steps.

As discussed previously, evidence-based guidelines and recommendations from reputable peer-reviewed journals are fundamental to clinical practice, as they assist providers with clinical decision making. I have attached for your reference below the Global Initiative for Asthma (GINA) report, which is a collaborative report between the World Health Organization (WHO) and the US Department of Health and Human Services National Heart, Lung, and Blood Institute (NHLBI).

Slide 1:
Title: A Stepwise Approach to Managing Asthma
Slide 2:
Long-term Control and Quick Relief Medications
Long-term control: inhaled corticosteroids (ICS), leukotriene modifiers, long-acting beta2-agonists (LABA), theophylline
Quick relief: short-acting beta2-agonists (SABA), ipratropium
Slide 3:
The Stepwise Approach
Step 1 (mild intermittent): SABA as needed
Step 2 (mild persistent): Low-dose ICS
Step 3 (moderate persistent): Low-dose ICS and LABA or medium-dose ICS
Step 4 (severe persistent): Medium- or high-dose ICS and LABA, leukotriene modifier, or theophylline (Global Initiative for Asthma, 2022) custom essay writing service.
Slide 4:
Benefits of the Stepwise Approach
Individualizes treatment based on symptom severity and risk of exacerbations
Provides clear guidance on medication adjustments to achieve control and reduce future risk (National Asthma Education and Prevention Program, 2007)
Slide 5:
Case Study: Applying the Approach
28yo female with moderate persistent asthma, uncontrolled on albuterol and Flovent
Step up to Flovent and Serevent, patient education on adherence and triggers
At follow-up, symptoms well-controlled on new regimen
Slide 6:
Global Initiative for Asthma. (2022). Global strategy for asthma management and prevention. https://ginasthma.org

National Asthma Education and Prevention Program. (2007). Expert panel report 3: Guidelines for the diagnosis and management of asthma. https://www.nhlbi.nih.gov/health-topics/guidelines-for-diagnosis-management-of-asthma

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