Independent Study Mentorship

By: Sergio SanchezMrs. Click 7th Period

Spring 2014

Mentor • Mrs. Amy Katherine Haverty she is Pediatric

Nurse Practitioner at UTMB Health and Pediatrics & Adult Primary Care.

• Mrs. Haverty graduated from Marquette University as Registered Nurse in 1994.

• She spent five years as an RN on active duty with the Army

• She began working as a nurse practitioner in 2007.

"Amy Katherine Haverty, PNP." UTMB Health - Amy Katherine Haverty. N.p., n.d. Web. 23 Feb. 2014.

Mentorship Site

Project Topic

• An overview of Asthma and its etiology.• The signs and symptoms of asthma• Diagnosing asthma• Preventing asthma• Asthma Action Plans• Discussing its Pharmacological Therapies

Epidemiology

• 15 million people in the United States have Asthma, 5 million being children or adolescents.

• Childhood Asthma is responsible for:– 13 million Physician visits.– 200,000 hospitalizations.– 550,000 emergency department visits. – 8 million prescriptions.

What is Asthma?

• Asthma is a chronic lung disease characterized by 3 features. – Airway obstruction that is at least partially

reversible.– Airway hyper-reactivity or hyper-responsiveness to

a variety of external stimuli. – Chronic inflammation of the airway.

"Asthma." Definition. Mayo Clinic Staff, 14 Feb. 2014. Web. 23 Feb. 2014.

Etiology

• Common triggers of Asthma– Viral Respiratory Infections – Exercise – Smoking– Family History – Pets– Environmental triggers

Allergens • Animal Dander • Dust• Food• Mold • Cockroaches • Change in weather usually cold air• Emotional expression such as laughter or anger• Gastroesophageal Reflux Disease (GERD-Reflux)

Signs and Symptoms

• Exacerbations– Wheezing – Retractions – Shortness of breath – Cyanosis

Exercise-Induced Asthma • Younger patients may experience flare ups

after running or riding a bike. • Physical exam may be preformed in clinic,

then medical provider checks for asthma symptoms.

• Peak-Flow Meter may be used to set a base line.

• Breathing second-hand smoke, also known as passive smoking and is harmful to the lungs.

• Tobacco smoke irritates the airways in the lungs. • No one should smoke near or in an area where a

child is present. • Children who live with a smoker in the

household are less likely to grow out there asthma, and more likely to need more medications and emergency room hospital visits.

Smoking

Status Asthmaticus • A severe asthma attack that does not respond

to the usual treatment. • Symptoms include extreme trouble breathing,

inability to speak, bluish tinged lips, heavy sweating and unconsciousness.

• Health Care providers will measure oxygen saturation levels and order the patient oxygen.

• Patient is usually hospitalized and may be treated in ICU, with IV medicine and steroids.

Classification of Severity Mild

Intermittent Symptoms < 2 days per week

Or2 nights per monthExacerbations brief

Mild Persistent Symptoms > 2 times per week, but < 1 time per day

Or< 2 nights per month

Moderate Persistent Daily Symptoms Or

more than 1 night per week

Severe Persistent Continual Symptoms Or

Frequent nighttime symptoms

Hollier, Amelie. "Asthma." Clinical Guidelines in Primary Care: A Reference and Review Book. Lafayette: Advanced PracticeEducation Associates, 2011. 588+. Print.

Treatment Approach

• Prevent chronic and troublesome symptoms.• Maintain normal or near normal pulmonary

function.• Maintain normal activity levels, including

exercise.• Prevent exacerbations.• Provide optimal medical regimen.

Delivering Asthma Medications

• Inhaler - Asthma inhalers are hand-held portable devices that deliver medication to your lungs.

• Nebulizer Machine – Medication is delivered via face mask.

• Spacer – Aerochamber device used to deliver medication more effectively and accurately to young children.

• Spirometer – A diagnostic device that measures the amount of air you're able to breathe in and out and the time it takes you to exhale completely after you take a deep breath.

• Peak Flow Meter - It measures how fast they can blow air out of their lungs.

PharmacologicalManagement

              

               

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Pharmacologic Therapy

– Short acting B-Agonists (SABA)• Albuterol nebulizer treatment or inhaler • Albuterol is used as rescue inhaler

– Systemic Corticosteroids • Oral or IV steroids

– Inhaled Corticosteroids • Inhalers

Hollier, Amelie. "Asthma." Clinical Guidelines in Primary Care: A Reference and Review Book. Lafayette: Advanced PracticeEducation Associates, 2011. 588+. Print.

Short Acting Beta Antagonists (SABA)

• Albuterol and Xopenex. • Quick-Relief, reliever or rescue medications. • This medicine is not intended to be used for

daily. • SABAs quickly cause bronchodilation by

relaxing the smooth muscle of the bronchi.

• Flovent and Qvar are two of the most commonly used.

• Blocks action of acetylcholine causing bronchodilation.

• ICS decrease activity of inflammatory cells. • Steroid activity is local in the lungs and is

associated with minimal systemic absorption.• Patient should always rinse mouth. Hollier, Amelie. "Asthma." Clinical Guidelines in Primary Care: A Reference and Review Book. Lafayette: Advanced PracticeEducation Associates, 2011. 588+. Print.

Inhaled Corticosteroids (ICS)

Long Acting BetaAntagonist (LABA)

• Considered a controller medicine, since it is taken every day.

• LABAs do not give quick relief of wheezing in acute attacks.

• They should never be used as the only treatment for asthma.

• They are usually prescribed with an inhaled corticosteroid.

Winland-Brown, Jill E., Brian O. Porter, and Debera J. Thomas. "Asthma." Primary Care The Art and Science of Advanced Practice Nursing. By Lynne M. Dunphy. 3rd ed. Philadelphia: F.A . Davis, 2011. 339+. Print.

Oral Steroids

• Also known as systemic corticosteroids. • May be taken as a controller medicine to treat

severe asthma. • Are usually prescribed for a patient to take

home after an asthma flare up. • An example is Prednisone. • Patients should be reminded to take with food

to prevent an upset stomach.

Works Cited • "Amy Katherine Haverty, PNP." UTMB Health - Amy Katherine

Haverty. N.p., n.d. Web. 23 Feb. 2014.• "Asthma." Definition. Mayo Clinic Staff, 14 Feb. 2014. Web. 23 Feb. 2014.• Hensley, Rhonda. "Asthma." Clinical Guidelines In Primary Care: A

Reference and Review Book. By Amelie Hollier. Lafayette: Advanced Practice Education Associates, 2011.588+. Print. Advanced Practice Education Associates.

• Hollier, Amelie. "Asthma." Clinical Guidelines in Primary Care: A Reference and Review Book. Lafayette: Advanced PracticeEducation Associate

• Papadakis, Maxine A. "Asthma." CURRENT Medical Diagnosis & Treatment. By Stephen J. McPhee. 50th ed. United States of America: McGraw-Hill Companies, 2011. 240+. Print.

• Winland-Brown, Jill E., Brian O. Porter, and Debera J. Thomas. "Asthma." Primary Care The Art and Science of Advanced Practice Nursing. By Lynne M. Dunphy. 3rd ed. Philadelphia: F.A . Davis, 2011. 339+. Print.

Acknowledgements

• Mrs. Amy Haverty • Mrs. Click• Evaluators • Family • Friends