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

Introduction

Asthma is a chronic, inflammatory disease of the airways

It affects 22 million Americans, of whom 6 million are children

It is associated with many negative impacts on individuals, families, and the
nation at large

Remarkable steps have been made towards its management

Both quick-relief and Long-term control medicines are used

Treatment Options

Quick relief works immediately to heal symptoms when they appear

Commonly targeted symptoms are wheezing, coughing, and shortness of breath

The most-prescribed quick-relief medicines are quick-acting bronchodilators such
as beta2-agonists

Long-term control medicines work over a period of time to ease airway
inflammation and prevent asthma symptoms.

The most common ones are the inhaled corticosteroids

These medications keep asthma controlled and in the green zone

Asthma Stepwise Management

The National Asthma Education and Prevention Program has recommended a stepwise
management approach to asthma (Yawn & Han, 2017)

Step one

Short-acting beta-agonist (SABA) such are albuterol prn are administered

If the patient reports no change after two days of use, other treatment options are made
(Yawn & Han, 2017)

Step two

Low-dose inhaled steroid are preferred

Leukotriene blocker or cromolyn can act as alternatives

Step three

Low-dose inhaled steroid is combined long-acting beta-agonist (LABA)

A combination of Medium-dose inhaled steroid and leukotriene blocker provides an
alternative

Step four

According to Rothe et al. (2018), a combination of Medium-dose inhaled steroid and
long-acting beta-agonist are preferred

The alternative is Medium-dose inhaled steroid plus leukotriene blocker

Step five

High-dose inhaled steroid and long-acting beta-agonist are preferred

Also, omaluzimab is considered for allergies

Step six

High-dose inhaled steroid plus long-acting beta-agonist and oral steroid are preferred

Also, omaluzimab is considered for allergies

Alternative is a High-dose inhaled steroid and leukotriene blocker combined with oral
steroid (White et al., 2018)

Assistance to Health Care Givers

The stepwise approach helps care providers to achieve and maintain control of
asthma

Physicians adjust the dose and number of medications and frequency of
administration

Step up will regain control while step down will maintained the control

This help this determining the minimum amount of medications for a patient and
reduce risks of side effects.

Also Read:

PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS

DIABETES AND DRUG TREATMENTS

DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL

COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER

WOMEN’S AND MEN’S HEALTH, INFECTIOUS DISEASE, AND HEMATOLOGIC DISORDERS

OFF-LABEL DRUG USE IN PEDIATRICS

References

Kirenga, B. J., Schwartz, J. I., de Jong, C., van der Molen, T., & Okot-Nwang, M. (2015). Guidance on
the diagnosis and management of asthma among adults in resource limited settings. African health
sciences, 15(4), 1189-1199.

Rothe, T., Spagnolo, P., Bridevaux, P. O., Clarenbach, C., Eich-Wanger, C., Meyer, F., & Sauty, A.
(2018). Diagnosis and management of asthma–the swiss guidelines. Respiration, 95(5), 364-380.

Yawn, B. P., & Han, M. K. (2017, November). Practical considerations for the diagnosis and
management of asthma in older adults. In Mayo Clinic Proceedings (Vol. 92, No. 11, pp. 1697-1705).
Elsevier.

White, J., Paton, J. Y., Niven, R., & Pinnock, H. (2018). Guidelines for the diagnosis and management
of asthma: a look at the key differences between BTS/SIGN and NICE. Thorax, 73(3), 293-297.

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 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL

Integrating Evidence-Based Practices in Complex Pain Management: A Case Study Analysis 

Introduction 

Complex Regional Pain Syndrome (CRPS), a challenging neurological condition, demands a nuanced and evidence-based approach to alleviate suffering and enhance patients’ quality of life. This in-depth analysis delves into the intricate case of a 43-year-old white male diagnosed with CRPS in his right hip. Through a series of carefully considered decisions, this patient’s journey sheds light on the complexities of managing CRPS while balancing medication side effects and therapeutic outcomes. 

Patient Summary 

The patient’s ordeal commenced seven years ago, following a fall at work resulting in significant right hip injury. Despite extensive diagnostic tests, he faced skepticism from healthcare professionals, leading to delays in appropriate treatment. The decisions taken included initiating amitriptyline at 25 mg, titrating to 125 mg at bedtime, and later reducing the dosage to 100 mg daily. These decisions were geared towards mitigating pain, enhancing functionality, and minimizing side effects such as grogginess and weight gain. 

Evidence-Based Support for Decisions 

The initiation of amitriptyline aligns with studies demonstrating its efficacy in managing neuropathic pain, particularly CRPS (Neyama et al., 2020). Amitriptyline, a tricyclic antidepressant, modulates pain perception through multiple pathways, making it a cornerstone in neuropathic pain management (Solomon et al., 2022). The decision to maintain the dose despite minor weight gain is substantiated by research indicating that the benefits of pain control often outweigh modest side effects (Naguib et al., 2021). Additionally, the avoidance of Qsymia was prudent, considering its potential cardiac risks and the patient’s BMI falling below the recommended threshold for its use (Lei et al., 2021). 

In addition to pharmaceutical interventions, exploring alternative therapies such as neuromodulation techniques has gained significant attention. A comprehensive study by Sivanesan, & Goebel (2021) delves into the effectiveness of spinal cord stimulation and peripheral nerve stimulation in managing Complex Regional Pain Syndrome, providing valuable insights into diverse treatment modalities.  

Goals and Outcomes 

The overarching goal was to reduce the patient’s pain levels to an acceptable threshold (around 3 on the scale) and restore his ability to perform daily activities without crutches. The outcomes were remarkably positive; the patient’s pain diminished from a debilitating 9 to a manageable 4. This reduction facilitated enhanced mobility and daily functioning, marking a significant improvement in his overall well-being. Despite minor weight gain, the patient’s improved quality of life underscored the success of the interventions. 

Discrepancies Between Expectations and Results 

In this case, the outcomes closely mirrored the expectations. The patient experienced a substantial reduction in pain, improved functionality, and minimal side effects, including manageable weight gain. The decisions made successfully struck a delicate balance between therapeutic benefits and potential drawbacks, ensuring the patient’s optimal quality of life. The minor weight gain, while a concern, was overshadowed by the vast improvements in pain control and functionality, aligning with the patient’s stated preferences. 

Conclusion 

CRPS management necessitates a holistic and individualized approach, integrating evidence-based practices, patient preferences, and vigilant monitoring of outcomes. This case study underscores the pivotal role of healthcare providers in navigating the complexities of CRPS treatment. By employing a comprehensive understanding of available therapies and their potential effects, clinicians can significantly enhance the lives of individuals afflicted with this debilitating condition. 

References 

Lei, X., Ruan, J., Lai, C., Sun, Z., Yang, X., Lei, X.-G., & Ruan, J.-Q. (2021). Efficacy and Safety of Phentermine/Topiramate in Adults with Overweight or Obesity: A Systematic Review and Meta-Analysis. Obesity (19307381), 29(6), 985–994. https://doi.org/10.1002/oby.23152 

Naguib, I. A., Ali, N. A., Elroby, F. A., & Elghobashy, M. R. (2021). Green HPLC-DAD and HPTLC Methods for Quantitative Determination of Binary Mixture of Pregabalin and Amitriptyline Used for Neuropathic Pain Management. Journal of Chromatographic Science, 59(6), 536–547. https://doi.org/10.1093/chromsci/bmab031 

Neyama, H., Dozono, N., Uchida, H., & Ueda, H. (2020). Mirtazapine, an α 2 Antagonist-Type Antidepressant, Reverses Pain and Lack of Morphine Analgesia in Fibromyalgia-Like Mouse Models. The Journal of Pharmacology and Experimental Therapeutics, 375(1), 1–9. https://doi.org/10.1124/jpet.120.265942 

Sivanesan, E., & Goebel, A. (2021). Complex regional pain syndrome: developing diagnostic tools and treatments from sympathetic nervous system, neuroimmune and neuromodulation discoveries in neuropathic pain. Regional Anesthesia & Pain Medicine, 46(3), 193–195. https://doi.org/10.1136/rapm-2020-101644 

Solomon Tesfaye, Gordon Sloan, Jennifer Petrie, David White, Mike Bradburn, Tracey Young, Satyan Rajbhandari, Sanjeev Sharma, Gerry Rayman, Ravikanth Gouni, Uazman Alam, Steven A Julious, Cindy Cooper, Amanda Loban, Katie Sutherland, Rachel Glover, Simon Waterhouse, Emily Turton, Michelle Horspool, … Dinesh Selvarajah. (2022). Optimal pharmacotherapy pathway in adults with diabetic peripheral neuropathic pain: the OPTION-DM RCT. Health Technology Assessment, 26(39). https://doi.org/10.3310/RXUO6757