NURS 6521 week 3 Assignment: Asthma and Stepwise Management

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 a trigger often induces symptoms and attacks, advanced practice nurses must also help patients identify 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.NURS 6521 week 3 Assignment

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 gain and maintaining control of the disease.NURS 6521  2 Assignment

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 procedure 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 and 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 gain and maintaining control of the disease. Be specific.
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The Step-wise Management of Asthma

Step-down or step-up therapies can be used in a step-wise approach to asthma management.

Step-down therapy entails starting with a high-dose treatment and gradually decreasing it over time if adequate control is not achieved (Falk, Hughes, & Rodgers, 2016). The step-up approach has the opposite effect.

Asthma affects both children and adults and is a significant public health issue worldwide. The primary goal of treatment is to prevent symptoms by controlling airway hyperreactivity and inflammation.

Long-term Control and Quick Relief Treatment

Long-term control entails taking medication daily to achieve and maintain chronic asthma control.

Long-term control medications commonly used include Advair, QVAR, Flovent, Pulmicort, and Singulair (Bonewit-West, Hunt, & Applegate, 2015).

On the other hand, quick-relief medications provide immediate relief for asthmatic symptoms such as wheezing, chest tightness, and coughing.

Maxiar, Proventil HFA, Ventolin HFA, Xopenex, albuterol, and ProAir HFA are medications used for immediate relief.

The most common long-term medications are corticosteroids, immunomodulators, leukotriene modifiers, and long-acting beta-agonists. On the other hand, quick-relief medications relieve asthma symptoms as soon as they occur.

Potential Impacts of Medication on Patients

Asthma medications, both long-term and short-term, can have side effects on patients.

Inhaled corticosteroids prevent symptoms but do not stop an attack once it has started (Gibson, 2019).

Oral candidiasis, sore throat and mouth, short-term dysphonia, reduced bone density (adults), cataract, glaucoma, tracheal spasms (reflex coughs), and slightly reduced growth in children are all possible side effects of inhaled corticosteroids (Walsh, 2019).

Short- and long-acting beta antagonists can cause increased pulse rate, anxiety, rash, dizziness, and headache.

Gargling and rinsing after inhaling corticosteroids can help prevent local side effects. The side effects of beta antagonists are short-lived. However, using a rescue inhaler excessively increases the risk of a severe attack.

The Step-wise Approach – Patients

The step-wise approach to asthma treatment and management can include either step-down or step-up therapy (Bernstein& Mansfield, 2019).

Step-up therapy entails starting with a low-dose treatment and gradually increasing it until optimal control.

Step-won therapy, on the other hand, involves starting with a higher dose and gradually lowering it as asthma control stabilizes.

In the treatment and management of asthma, step-down therapy appears to be more effective and beneficial.

Doctors frequently recommend step-down approaches for those with confirmed cases of asthma. This is because it reduces the patient’s exposure to potentially harmful effects of medication while also simplifying the patient’s medication regimen. This promotes better adherence.

The Step-Wise Approach-Care Providers

The step-by-step approach assists both caregivers and patients in gaining and maintaining asthma control.

Health care providers use the approach to supplement, not replace, the clinical decision-making required to meet individual patients’ needs (Craig, 2014).

Alternative treatments are frequently used, and if the response is inadequate, they are discontinued, and the preferred treatment is used before stepping up.

The step-wise approach aids both caregivers and patients maintain effective control and management.


Asthma is frequently misdiagnosed and undertreated.

Inhaled corticosteroids are now widely available and used, which has reduced adverse events and improved outcomes.

One method used to control, manage, and treat the condition is the step-wise approach, which includes step-up and step-down therapies.

The approach should be used as a supplement to, not as a replacement for, care decisions necessary to meet individual patients’ needs.


  • Falk, N. P., Hughes, S. W., & Rodgers, B. C. (2016). Medications for chronic asthma. American Family Physician, 94(6), 454-462.
  • Bernstein, J. A., & Mansfield, L. (2019). Step-up and step-down treatments for optimal asthma control in children and adolescents. Journal of Asthma, 56(7), 758-770.
  • Craig, T. J. (2014). Physician implementation of asthma management guidelines and recommendations: 2 case studies—Journal of the American Osteopathic Association, 114(11), eS4-eS15.
  • Bonewit-West, K., Hunt, S., & Applegate, E. (2015). Today’s medical assistant: Clinical & administrative procedures. London, UK: Elsevier Saunders.
  • Gibson, P. (2019). Monitoring asthma. Boca Raton, FL: Taylor & Francis.
  • Walsh, B. K. (2019). Neonatal and pediatric respiratory care. St. Louis, MO: Elsevier.