Question

Joshua Jackson is a 27-year-old Caucasian man. He was diagnosed with asthma at the age of 8. He presents to the physician’s office complaining of increased shortness of breath and coughing, especially at night, despite using his albuterol (Proventil) inhaler one or two inhalations every 4 to 6 hours as needed. The physician classifies Mr. Jackson’s asthma as Step 3 persistent. (Learning Objectives 1, 2, 4)

1.     What medications are recommended to treat Mr. Jackson’s asthma?

2.     What environmental controls can Mr. Jackson use to help control his asthma?

3.     Before Mr. Jackson leaves the office, what should the nurse go over with him?

Answer 1

1) The physician classified his asthma as step 3 persistent.

He should go for a preferred controller medication including low dose inhaled corticosteroids along with long acting beta agonist. This combination medication is preferred to have better results.

Inhaled medium dose of corticosteroids is otherwise given as single medication.

2) Donot expose to inhalant allergens, particularly indoor inhalant allergens.

Tobacco smoke and other irritants can worsen the condition.

Wood burned stoves, unvented gas heaters etc are allergic to many.

strong odours of fresh paint and perfume may act as allergens.

Pollens of flowers, wild grasses are the major cause of respiratory allergy.

Household pet dander contribute to symptom of inhalant allergy.

3) Nurses should counsel them about the inhaler technique to use.

Give support and advice for patient to avoid asthma triggers.

Teach them about the medication and dose to take.

Ask for cooperation to devolop a personalised asthma plan.

Tell them to review the conditions in a regular basis