NURS 6521 ASTHMA AND STEPWISE MANAGEMENT

Walden University NURS 6521 ASTHMA AND STEPWISE MANAGEMENT – Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 6521 ASTHMA AND STEPWISE MANAGEMENT  assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 6521 ASTHMA AND STEPWISE MANAGEMENT 

Whether one passes or fails an academic assignment such as the Walden University NURS 6521 ASTHMA AND STEPWISE MANAGEMENT  depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 6521 ASTHMA AND STEPWISE MANAGEMENT 

The introduction for the Walden University NURS 6521 ASTHMA AND STEPWISE MANAGEMENT  is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 6521 ASTHMA AND STEPWISE MANAGEMENT 

After the introduction, move into the main part of the NURS 6521 ASTHMA AND STEPWISE MANAGEMENT  assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 6521 ASTHMA AND STEPWISE MANAGEMENT 

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 6521 ASTHMA AND STEPWISE MANAGEMENT 

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 6521 ASTHMA AND STEPWISE MANAGEMENT

• Asthma is a respiratory disorder characterized by swelling and inflammation of the airways making them narrow, and overproduction of mucus. ​
• The age of onset of asthma is usually during the first 6 years of life accounting for 80% of the reported cases (Azmeh et al., 2020). ​
• Some of the common side effects of asthma in both children and adults include: ​
• Chest Tightness​
• Shortness of Breath ​
• Wheezing ​
• Coughing (Papi et al., 2020).​

Management of Asthma

• The pharmacological approaches of asthma management have been divided into two main categories, quick-relief medications and long-term control (Khurana & Jarjour, 2019). ​
• To determine which pharmacological approach to use for the patient, it is necessary to find out how severe the patient’s asthmatic condition is (Martin et al., 2022). ​
• Recommended diagnostic tests:​
• Lung function tests;​
• Peak flow​
• Nitric oxide measurement​
• Pulse oximetry​
• Spirometry (Witt et al., 2022)

Management of Asthma Cont.

• For patients with an acute asthmatic attack, quick relief pharmacological management is recommended. ​
• Drugs such as oral corticosteroids like prednisolone and short-acting beta blockers like salbutamol are recommended for quick relief management of asthma (Mauer & Taliercio, 2020). ​
• Patients with severe and persistent asthma require long-term therapy, which involves the use of several drugs including:​
• Corticosteroids​
• Long-acting Beta-agonists (LABAs),​
• Leukotriene Modifiers​
• Immunomodulators for children above the age of 12 years (Beasley et al., 2020).​

Benefits of Stepwise Approach​

• To the Healthcare Provider​
• Provides guidance when starting the treatment for a given patient who has been recommended for long-term therapy (Mauer & Taliercio, 2020). ​
• Helps choose the most effective and well-tolerated medication at an optimal dose, hence reducing the risks of side effects.​
• Helps in safe and effective therapy adjustment based on the level of asthma control (Beasley et al., 2020)​
• To the Patient​
• Reduced incidences of recurrent exacerbations of asthmatic symptoms​
• Reduced number of visits to the emergency department and hospitalization,​
• Reduced risks of adverse effects with long-term use of medication (Rothe et al., 2018). ​

Conclusion​

• Asthma is a significantly disabling respiratory condition that is characterized by symptoms affecting normal breathing. ​
• The diagnosis of this respiratory disorder is usually done by use of lab tests such as spirometry, lung function test, pulse oximetry, peak flow, and nitric oxide measurement. ​
• In acute cases, quick relief pharmacological agents are usually used to control the patient’s symptoms. ​
• In severe and persistent cases, patients are shifted to long-term therapy that involves the utilization of the stepwise approach to ensure positive outcomes. ​

References​

• Azmeh, R., Greydanus, D. E., Agana, M. G., Dickson, C. A., Patel, D. R., Ischander, M. M., & Lloyd, R. D. (2020). Update in Pediatric Asthma: Selected Issues. Disease-a-Month, 66(4), 100886. https://doi.org/10.1016/j.disamonth.2019.100886​
• Beasley, R., Braithwaite, I., Semprini, A., Kearns, C., Weatherall, M., & Pavord, I. D. (2020). Optimal Asthma Control: Time for a New Target. American Journal of Respiratory and Critical Care Medicine, 201(12), 1480–1487. https://doi.org/10.1164/rccm.201910-1934ci​
• Khurana, S., & Jarjour, N. N. (2019). Systematic Approach to Asthma of Varying Severity. Clinics in Chest Medicine, 40(1), 59–70. https://doi.org/10.1016/j.ccm.2018.10.004​
• Martin, J., Townshend, J., & Brodlie, M. (2022). Diagnosis and management of asthma in children. BMJ Paediatrics Open, 6(1), e001277. https://doi.org/10.1136/bmjpo-2021-001277​
• Mauer, Y., & Taliercio, R. M. (2020). Managing adult asthma: The 2019 GINA guidelines. Cleveland Clinic Journal of Medicine, 87(9), 569–575. https://doi.org/10.3949/ccjm.87a.19136​
• Papi, A., Blasi, F., Canonica, G. W., Morandi, L., Richeldi, L., & Rossi, A. (2020). Treatment strategies for asthma: reshaping the concept of asthma management. Allergy, Asthma & Clinical Immunology, 16(1). https://doi.org/10.1186/s13223-020-00472-8​
• Rothe, T., Spagnolo, P., Bridevaux, P.-O., Clarenbach, C., Eich-Wanger, C., Meyer, F., Miedinger, D., Möller, A., Nicod, Laurent P., Nicolet-Chatelain, G., Sauty, A., Steurer-Stey, C., & Leuppi, Joerg D. (2018). Diagnosis and Management of Asthma – The Swiss Guidelines. Respiration, 95(5), 364–380. https://doi.org/10.1159/000486797​
• Witt, A., Douglass, J. A., & Harun, N. (2022). Overview of recent advancements in asthma management. Internal Medicine Journal, 52(9), 1478–1487. https://doi.org/10.1111/imj.15904​

Sample Answer 2 for NURS 6521 ASTHMA AND STEPWISE MANAGEMENT

Introduction

Asthma is a respiratory disorder characterized by swelling and inflammation of the airways making them narrow, and overproduction of mucus. In most patients, the age of onset of asthma is usually during the first 6 years of life accounting for 80% of the reported cases (Azmeh et al., 2020). However, diagnosis of this disorder among pediatric patients is usually very challenging due to the varied symptoms with age (Martin et al., 2022). Some of the common side effects of asthma in both children and adults include chest tightness, shortness of breath, wheezing, and coughing (Papi et al., 2020).

Management of Asthma

The treatment of asthma mainly involves the use of medication. The pharmacological approaches have been divided into two main categories, quick-relief medications and long-term control (Khurana & Jarjour, 2019). To determine which pharmacological approach to use for the patient, it is necessary to find out how severe the patient’s asthmatic condition is (Martin et al., 2022). Several diagnostic tests have been proven to be effective in the diagnosis and grading of asthmatic patients. Such diagnostic tests include spirometry, lung function test, pulse oximetry, peak flow, and nitric oxide measurement (Witt et al., 2022).

For patients with an acute asthmatic attack, quick relief pharmacological management is recommended. Drugs such as oral corticosteroids like prednisolone and short-acting beta blockers like salbutamol are recommended for quick relief management of asthma (Mauer & Taliercio, 2020). However, patients with severe and persistent asthma require long-term therapy, which involves the use of several drugs including corticosteroids, long-acting beta-agonists (LABAs), leukotriene modifiers, and immunomodulators for children above the age of 12 years (Beasley et al., 2020). A stepwise approach is used to determine which medication to use at different stages of the disease.

Stepwise Approach in Asthma Treatment (Children and Adults  ≥12 YEARS) 

The stepwise management of asthma varies with age. For patients above the age of 12 years, six main steps are recommended (Khurana & Jarjour, 2019). In the first step, a short-acting beta agonist like salbutamol is recommended. In the second step, a short-acting beta agonist (SABA) is recommended together with a low-dose inhaled corticosteroid (ICS) like fluticasone (Azmeh et al., 2020). In the third step, the patient is administered LABA together with low-dose ICS. The fourth step involves the use of LABA together with medium-dose ICS (Rothe et al., 2018). The fifth step involves the use of SABA together with Long-acting muscarinic antagonists (LAMA) and high-dose ICS-LABA (Papi et al., 2020). In the final step, high-dose SABA is recommended together with high-dose ICS-LABA and oral steroids.

Benefits of Stepwise Approach

The utilization of the stepwise technique in the management of asthmatic patients has displayed significant benefits to both the patient and medical practitioner in the past. For the practitioner, the stepwise approach provides guidance when starting treatment for a given patient who has been recommended for long-term therapy (Mauer & Taliercio, 2020). It also helps the practitioner choose the most effective and well-tolerated medication at an optimal dose, hence reducing the risks of side effects. The practitioner will also be able to effectively adjust the patient’s treatment regimen based on the level of asthma control (Beasley et al., 2020). The benefits to the patient include reduced incidences of recurrent exacerbations of asthmatic symptoms, reduced number of visits to the emergency department and hospitalization, and reduced risks of adverse effects with long-term use of medication (Rothe et al., 2018).

Conclusion

Asthma is a significantly disabling respiratory condition that is characterized by symptoms affecting normal breathing. The diagnosis of this respiratory disorder is usually done by use of lab tests such as spirometry, lung function test, pulse oximetry, peak flow, and nitric oxide measurement. In acute cases, quick relief pharmacological agents are usually used to control the patient’s symptoms. In severe and persistent cases, patients are shifted to long-term therapy that involves the utilization of the stepwise approach to ensure positive outcomes.

References

• Azmeh, R., Greydanus, D. E., Agana, M. G., Dickson, C. A., Patel, D. R., Ischander, M. M., & Lloyd, R. D. (2020). Update in Pediatric Asthma: Selected Issues. Disease-a-Month, 66(4), 100886. https://doi.org/10.1016/j.disamonth.2019.100886
• Beasley, R., Braithwaite, I., Semprini, A., Kearns, C., Weatherall, M., & Pavord, I. D. (2020). Optimal Asthma Control: Time for a New Target. American Journal of Respiratory and Critical Care Medicine, 201(12), 1480–1487. https://doi.org/10.1164/rccm.201910-1934ci
• Khurana, S., & Jarjour, N. N. (2019). Systematic Approach to Asthma of Varying Severity. Clinics in Chest Medicine, 40(1), 59–70. https://doi.org/10.1016/j.ccm.2018.10.004
• Martin, J., Townshend, J., & Brodlie, M. (2022). Diagnosis and management of asthma in children. BMJ Paediatrics Open, 6(1), e001277. https://doi.org/10.1136/bmjpo-2021-001277
• Mauer, Y., & Taliercio, R. M. (2020). Managing adult asthma: The 2019 GINA guidelines. Cleveland Clinic Journal of Medicine, 87(9), 569–575. https://doi.org/10.3949/ccjm.87a.19136
• Papi, A., Blasi, F., Canonica, G. W., Morandi, L., Richeldi, L., & Rossi, A. (2020). Treatment strategies for asthma: reshaping the concept of asthma management. Allergy, Asthma & Clinical Immunology, 16(1). https://doi.org/10.1186/s13223-020-00472-8
• Rothe, T., Spagnolo, P., Bridevaux, P.-O., Clarenbach, C., Eich-Wanger, C., Meyer, F., Miedinger, D., Möller, A., Nicod, Laurent P., Nicolet-Chatelain, G., Sauty, A., Steurer-Stey, C., & Leuppi, Joerg D. (2018). Diagnosis and Management of Asthma – The Swiss Guidelines. Respiration, 95(5), 364–380. https://doi.org/10.1159/000486797
• Witt, A., Douglass, J. A., & Harun, N. (2022). Overview of recent advancements in asthma management. Internal Medicine Journal, 52(9), 1478–1487. https://doi.org/10.1111/imj.15904

NURS_6521_ Advanced Pharmacology. Week 6_ Neurologic and Musculoskeletal Disorders and Opioids Assignment_ Decision Tree for Neurological and Musculoskeletal Disorders

Week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders 

Alzheimer’s is one of the most common progressive neurological disorders among the elderly caused by dementia. Patients will present with mild to moderate cognitive signs and symptoms at the onset of the disorder, which will progress to severe memory loss with time, as they grow much older (Li et al., 2019). However, several treatment options have been proven to be effective in the management of Alzheimer’s disorder among the elderly. The purpose of this discussion is to illustrate the decision process in selecting the most effective drug, based on pharmacokinetic and pharmacodynamic factors, for treating an elderly patient diagnosed with Alzheimer’s disease. 

Patient Case Study Summary 

 The assigned case study demonstrates a 76-year-old Iranian male with symptoms of Alzheimer’s disorder. The patient displays strange behavior upon arrival at the clinic reporting symptoms of memory loss, forgetfulness, confusion, and diminished interest in religious activities for the last 2 years. Pharmacokinetic and pharmacodynamic patient factors which contributed to the selection of drugs for this patient include his advanced age, male gender, Iranian race, and presenting symptoms in addition to the mini-mental exam results of moderate dementia. the patient’s diagnosis of Alzheimer’s disorder will also be considered. 

Treatment Decisions 

 Based on the patient history and the pharmacokinetic and pharmacodynamic factors mentioned above, the most appropriate intervention is to initiate Exelon 1.5mg twice daily. Exelon (rivastigmine) is an FFDA-approved drug for treating mild to moderate Alzheimer’s disease (Fish et al., 2019). Previous studies support great effectiveness, and safety profile for use of the drug among the elderly diagnosed with Alzheimer’s (Khoury et al., 2018). The second decision was to increase the dose of Exelon to 4.5 mg twice daily as recommended by most clinical practice guidelines for patients who have displayed great tolerance but with minimal effectiveness. The last decision was to increase the dose further to 6mg twice daily, to promote optimal effectiveness as the patient still displayed limited remission of symptoms with the previous intervention. 

Expected Outcome 

 Studies show that Exelon when administered appropriately takes between 8 to 12 weeks to completely manage symptoms of Alzheimer’s among elderly patients. As such, with the initial intervention of 1.5mg Exelon twice daily, the patient was expected to display approximately 50% remission of symptoms (Nguyen et al., 2021). The dose was however to be titrated to obtain the optimum outcome, not exceeding 6mg twice daily. The same results were expected with the second and third interventions with no side effects expected.  

Difference Between Expected Outcome and Actual Outcome 

 Just like expected, the patient displayed a minimal reduction of symptoms of Alzheimer’s with no side effects reported with the first intervention. After the dose was increased in the second intervention, the patient reported further remission of symptoms, but at a slow rate, hence increasing the dose in the last intervention, which led to optimal remission of Alzheimer’s symptoms just as expected (Huang et al., 2020).  

Conclusion 

Alzheimer’s is a common disorder among the elderly compromising their quality of life and well-being. For the patient in the provided case study, it was necessary to administer Exelon at a starting dose of 1.5 mg which was titrated to 4.5mg then 6.5mg twice daily. The patient displayed great effectiveness with this medication in the management of his Alzheimer’s symptoms, with no side effects reported.  

References 

Fish, P. V., Steadman, D., Bayle, E. D., & Whiting, P. (2019). New approaches for the treatment of Alzheimer’s disease. Bioorganic & medicinal chemistry letters, 29(2), 125-133. https://doi.org/10.1016/j.bmcl.2018.11.034 

Huang, L. K., Chao, S. P., & Hu, C. J. (2020). Clinical trials of new drugs for Alzheimer’s disease. Journal of biomedical science, 27(1), 1-13. https://doi.org/10.1186/s12929-019-0609-7 

Khoury, R., Rajamanickam, J., & Grossberg, G. T. (2018). An update on the safety of current therapies for Alzheimer’s disease: focus on rivastigmine. Therapeutic Advances in Drug Safety, 9(3), 171-178. https://doi.org/10.1177/2042098617750555 

Li, D. D., Zhang, Y. H., Zhang, W., & Zhao, P. (2019). Meta-analysis of randomized controlled trials on the efficacy and safety of donepezil, galantamine, rivastigmine, and memantine for the treatment of Alzheimer’s disease. Frontiers in neuroscience, 13, 472. https://doi.org/10.3389/fnins.2019.00472 

Nguyen, K., Hoffman, H., Chakkamparambil, B., & Grossberg, G. T. (2021). Evaluation of rivastigmine in Alzheimer’s disease. Neurodegenerative Disease Management, 11(1), 35-48. https://doi.org/10.2217/nmt-2020-0052