Asthma Case study on a 23-year-old female patient

Considering the clinical signs and history given, it can be stated that the 23-year-old female patient relapses a history of asthma during pregnancy. The patient reports asthma, diagnosed at the age of 8, whereby she used a Short Acting Beta 2 Agonist (SABA). The current signs include a dry cough and marked wheezing, both evident at a conversation’s volume, for three weeks. Because of the return of these respiratory symptoms, mainly the frequency and severity, the possibility of her persistent asthma, especially compounded by her pregnancy and recent stressors, can be assumed.

Asthma is recognized as volatile and ranges from mild to chronic. A concerned patient’s asthma can be categorized as mild to severe persistent, given the present symptoms such as wheezing, night-time waking up, and fatigue (Hashmi et al., 2023). Her Forced Expiratory Volume (FEV1) of 70% has slowed her lung function, and she has symptoms of moderate asthma that entail daily usage and night-time awakenings more than once per week. These findings explain why there is a need for unique, thorough and timely management to improve the status of both the mother and the fetus.

The first interventional strategy of the care plan will entail medication. Considering her present condition, she requires a form of inhalational therapy to decrease airway inflammation: an Inhaled corticosteroid. In short-term management, the treatment is a combination inhaler with a low ICS dose and a Long-Acting Beta Agonist, specifically Formoterol, due to asthma control’s quick onset and effectiveness (PubChem, 2019). This combination will enable the management of her daily symptoms to eliminate the worsening of symptoms at night.

Managed Care Organizations and Accountable Care Organizations

Inhaled corticosteroids are preferable during pregnancy because they are effective drugs whose safety profile is well understood. A SABA such as Albuterol should also be prescribed to alleviate prominent signs and symptoms significantly when the severity of the illness has worsened. This will aid in coping with any deterioration in breathing or wheezing, particularly in asthmatic people. It is necessary to explain to the patient how and when to use these medicines and how to apply the spacer to optimize the impact of the inhaled preparations.

Besides pharmacological therapy, it is crucial to talk about non-pharmacologic management, which is more critical regarding her current life conditions. First, patient education is required concerning initial and further asthma management (Asthma: Learn More – Non-Drug Interventions for Asthma, 2022). This comprises her precipitating factors, the correct methods of inhaler use, and signs of asthma deterioration. Second, a piece of written asthma action plan must be given. This plan should describe how she will cope with her physical signs and symptoms of exacerbation in the day and what measures to be taken in case of an asthma flare-up.

Third, administrative interventions and stress management strategies need to be applied. Since the patient has recently left an abusive situation, then help from a counsellor or going to support groups will help them cope with the problem. Fourth, there is the need to evaluate environmental influences and seek to regulate impact. These patients should avoid dust mites, tobacco smoke, whether firsthand or second-hand and any strong odors. Lastly, she should drink enough water and eat enough meals, which should also be addressed. The deficiency of nutrients can worsen asthma, and an average amount of water thins the secretions in the bronchi.

INNOVATION PROPOSAL ADVANCING EVIDENCE-BASED INNOVATION IN NURSING PRACTICE — D031

Community resources available for this patient in Bay City, Michigan:

The Bay Arenac Behavioral Health Services delivers programs and services to those who experience mental crises, trauma, and other mental disorders. Since she has recently relocated and possibly does not have any family or friends to consult with, these services might help her address the new environment psychologically.

The Bay County Health Department offers several services, beginning with prenatal care services, which can meet her routine pregnancy needs. At the same time, the health department can also closely check on her pregnancy complications arising from asthma.

The woman can go to the Women, Infants, and Children program, a supplement and food education program that can ensure that during this pregnancy, she gets all the nutrients she needs and that the child will.

A sound communication strategy must be emphasized, given the need to keep the patient in the middle of her treatment regimen. There is a need to ensure that this plan will incorporate assertiveness and therapeutic communication strategies like empathy, active listening, and patients’ self-assertion. Every time a doctor or nurse consults the patient, particular emphasis should be placed on developing a rapport so that the patient feels comfortable reporting the problem fully articulated. The open-ended questions will help the patient discuss her experiences and emotions about her health status and requirements.

This means there should be a new approach to the patient, which should be done by relating with them in a friendly manner. This is possible by engaging her in decision-making and explaining the reason for every recommended treatment and the likely benefits and drawbacks. Clear, simple directions in combination with teachers’ check-ins that employ teach-back methods can ensure that she follows her treatment plan accurately.

She should be encouraged to come for a follow-up visit to assess her asthma and make necessary modifications to the management. Such appointments are crucial for checking her lungs’ condition, medication compliance, and general health status. Furthermore, it would be advisable to offer telehealth choices for follow-up care as she released she has been transferred recently and does not have a car, transportation or caregiver’s help where constant trips are stressful.

Informational resources are also significant; goals relating to informational resources include offering the patient literature on managing asthma during pregnancy, local support group contacts, and coping methods. This is beneficial because the patient is knowledgeable about handling the condition appropriately. Suggesting that she use a symptom diary will enable her to record the severity of her signs and the probable cause, hence retrieving valuable data at the subsequent review for a more concrete management plan.

In conclusion, the patient’s case can be said to present acute moderate to severe persistent asthma, which she had been previously diagnosed with, and this might have been triggered by stress from her new circumstances or her pregnancy. The recommended therapies in the acute and post-acute periods should be medical and nonmedical interventions. The first pharmacological strategy should entail an ICS/LABA combination drug for maintenance and an SABA for rescue. Non-pharmacologic approaches must address patient education, stress reduction, environmental manipulation, and regulating drinking water and food intake.

Several organizations within the Bay City community can offer the needed help in a time like this. The mental health support that she needs can be provided at the Bay Arenac Behavioral Health Services, while her prenatal care can be done at the Bay County Health Department. Also, the WIC program can help provide her with the proper nutrition for her family’s health.

A detailed communication strategy that includes understanding the patient and her needs for involvement and follow-up is essential in her asthma management. Thus, achieving these goals using the interventions above would enhance her respiratory status and quality of life during pregnancy and throughout her life. This results in the dual advantage of managing the physical health of the mother and unborn child and the woman’s socio-emotional well-being. Such patient orientation with local community support and clear and sensitive communication with the patient will enable the patient’s active participation in further treatment. Hence, her overall health will be enhanced.

References

Asthma: Learn More – Non-drug interventions for asthma. (2022, July 20). Www.ncbi.nlm.nih.gov; Institute for Quality and Efficiency in Health Care (IQWiG). https://www.ncbi.nlm.nih.gov/books/NBK279518/#:~:text=Research%20suggests%20that%20sports%20and

Hashmi, M. F., Tariq, M., & Cataletto, M. E. (2023, May 3). Asthma. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430901/

PubChem. (2019). Formoterol. Nih.gov; PubChem. https://pubchem.ncbi.nlm.nih.gov/compound/Formoterol