Introduction
The respiratory system primarily consists of airways, the lungs, and blood arteries that feed the lungs. The breathing system also comprises a circulation component, which encompasses the rib cage and the diaphragm, formed of breathing muscles. This essay will evaluate a 25-week pregnant 23-year-old female who has had non-productive bronchitis for the previous three weeks and is wheezing audibly. These symptoms exist throughout the day and disturb her sleeping patterns at night, making the patient more exhausted during morning hours. Since this client is a newcomer to the region, society resources and a communication strategy will be offered to guarantee the patient’s compliance with the established arrangements. Moreover, once a diagnosis has been made, a non-pharmacologic and pharmacologic therapeutic plan will be developed for the patient.
Diagnosis and Rationale
The patient looks to be undergoing a severe asthma attack, predicated on the prior medical history and physical assessment. On the grounds of the patient’s medical history and physical examination, it was determined that her indications are symptomatic of a reoccurring blockage in her airways due to a stimulus-induced episode of bronchospasm (Robijn et al., 2019). During the physical examination, the woman had shallow breathing with a pulmonary function of 28 breaths per minute, periodic wheezing, and a non-productive cough that aggravated at night and awoke her from sleep. Furthermore, the patient had a considerable history of childhood asthma that persisted for around ten years and required the administration of a short-acting beta agonist (SABA) to manage relapses.
Upper respiratory infection (URI), bronchitis, and pneumonia can be ruled out at this time because the individual is afebrile, has an unproductive cough, and has been experiencing symptoms for the previous three weeks. In acute episodes, detectable and auscultatory wheezing can also assist in the diagnosis of asthma. Robijn et al. (2019) enumerated that the varied symptoms of this condition include breathlessness, coughing, chest tightness, difficulty breathing, and expiratory restriction of the airways. Wheezing is a clinical manifestation of any disease or disorder that causes respiratory distress. Asthmatics frequently experience it as a result of restriction of the lower airways.
Asthma is a long-term inflammatory lung illness characterized by pulmonary hyperreactivity, airway obstruction, and reduced airflow. The disease is more common in women between 20 and 50 years of age (Labor et al., 2018). Asthma during pregnancy is a frequent and rising threat to the health of women and infants. The condition is the most common respiratory ailment that impairs pregnancy, and despite advances in therapy, it remains an ailment associated with a significant risk of complications. As asthma affects gestation results, pregnancy likewise affects asthma (Labor et al., 2018). Pregnancy is associated with the emergence of asthma, and the intensity of underlying asthma can worsen throughout pregnancy.
Treatment Plan
Determining the prevalence of asthma will facilitate the development of an effective treatment protocol. It is critical to involve the individual in therapeutic interventions and to comprehend their treatment objectives. The client is the focal point of the medication regimen. For instance, a woman who is 25 weeks pregnant may decide not to take drugs due to their uncertain implications on the fetus. The initial symptoms commenced three weeks ago, but within that period, they became daily, present throughout the day, and caused her to awaken each night. Her increased weariness impacts the client’s everyday activities, and her FEV is 70%. Therefore, the patient lies between steps 3 and 4 since her FEV is higher than 60% but less than 80% (step 3). Nonetheless, her associated symptoms occur all day (step 4) (Miller, 2020). The long-term objectives of asthma care are symptom control and the minimization of possible risk for asthma morbidity, recurrence, airflow obstruction, and treatment-related adverse effects.
Global Initiative for Asthma (GINA) recommendations are worldwide asthma prevention and control measures. According to GINA (2021), step three commences with a modest dose of ICS-formoterol for management and alleviating medication (Beasley et al., 2022). The usage of budesonide-formoterol or beclomethasone-formoterol may be beneficial. The maximum daily dosage of budesonide-formoterol is 72 mcg metered dose (54 mcg administered in a dose), while the maximum daily amount of beclomethasone-formoterol is 48 mcg metered dose (36 mcg delivered dose). This individual may gain better from a sustained ICS-LABA with an as-needed SABA; therefore, prescribe a modest dose of fluticasone propionate formoterol in conjunction with an albuterol inhaler for emergency use.
Pregnancy and the desire to keep the fetus safe necessitate incorporating non-pharmaceutical treatments. Typically, non-pharmacologic therapies are used in conjunction with drugs and may involve avoiding particular settings, pursuing physical exercise, and implementing educational activities. It is essential to prevent exposure to cigarette smoke, restrict physical activity if it exacerbates asthmatic symptoms, adopt a healthy diet, such as reducing fatty and junk foods, and avoid drugs that may aggravate asthma. Educating asthmatics on respiratory relaxation exercises, such as inhaling slowly and deeply through the nose and exhaling through the mouth, helps reduce breathlessness and enables calm, regulated breath during asthma episodes.
Community Resources
This pregnant woman is eligible for Medicaid healthcare during her gestation and remains covered after giving birth. While a portion of this insurance is offered at no cost, other solutions are purchased at a nominal fee. In the USA, there are neighborhood resources that will assist this individual. For instance, the Nevada Department of Health and Human Services offers medical aid to individuals and households through a diverse range of programs. In addition to medical consultations, drugs, eye exams, and therapies, a variety of services are provided. I would also inform the individual about the numerous pharmaceutical support initiatives available to receive prescriptions at a reduced cost, such as RxAssist, NeedyMeds, and GoodRx, which monitors pricing, issues vouchers, and cashback offers online.
Moreover, I would provide information about the Women, Infants, and Children (WIC) project, which offers complementary nourishment for low-income expectant, postnatal, and breastfeeding women, newborns, and toddlers up to the age of five who are at likelihood of malnutrition. WIC assists by offering education, nutritional supplements, and links to medical professionals. The personnel of the WIC project interact with many health practitioners and social welfare specialists to guarantee that members get the best quality of care. The U.S. Environmental Protection Agency increases empirical understanding of environmental precipitating factors and solutions for controlling asthma in group settings through investigation, teaching, and awareness. Through a partnership with government, statewide, and regional allies, they are enhancing the country’s capability to regulate asthma and minimize susceptibility to outdoor and indoor contaminants linked to asthma.
The Help Society of the Asthma and Allergy Foundation of America is a tremendous resource for linking clients, families, colleagues, and professionals who require assistance and encouragement. Furthermore, health providers should advise caregivers and their patients to see asthma-educational videos discoverable online or offer them a complimentary asthma periodical. The American Lung Association is the most outstanding institution dedicated to saving individuals through instruction, investigation, and lobbying about lung health. They give resources to aid numerous Americans in addressing lung problems such as asthma and push for laws emphasizing public health by enhancing lung health, reducing tobacco use, safeguarding individuals from smoke inhalation, and cleaning up pollution levels.
Communication Plan
Before conception, all asthmatic women of reproductive age should get good training, mitigate future triggers, and titrate medications, if possible. Medication coordinated by a cooperative interdisciplinary team, verifiable evidence, and frequent hospital visits support improved outcomes (Bonham et al., 2018). Healthcare organizations must customize their interactions to the client’s level of medical literacy and enhance their knowledge of health disparities and ethnic barriers to accomplish a more appropriate communication scheme with minority or economically challenged patients regarding the use of inhaled steroids that have been shown to improve asthma consequences.
Regular follow-up meetings must consider treatment objectives and any complaints, aspirations, or requirements so that individuals are significantly more engaged in the comprehensive asthma action plan (AAP). According to Gruffydd-Jones & Hansen (2020), it is essential for patients and medical practitioners to consider the relevance of present management and future risk mitigation. A documented AAP aids patients in self-management by providing clearly stated guidelines and directions on how to self-manage their asthma daily, including taking medications accurately and realizing and minimizing vulnerability to toxicants and allergens that may trigger asthma symptoms. The AAP offers instructions on how to diagnose and treat severe asthma and when and who to contact in an urgent situation.
Education aims to enhance patient adherence, normalize medicine according to AAP guidelines, teach clients effective breathing techniques, and instruct them on how to self-monitor their well-being. Zhang et al. (2021) underlined that patient instruction, a non-pharmacologic approach, is as essential as pharmacological treatment. Due to the potential risks of pharmaceuticals to the mother and fetus, improper medication management and incorrect use of inhaled medications add significantly to the difficulties of treating asthma, especially in pregnant women (Zhang et al., 2021). Various attempts have been launched to expand access to standard exams. Telephone appointments with nurses can increase the number of individuals screened for asthma administration and enable patients to negotiate and execute individualized asthma plans. Telehealth may improve clinical trial outcomes for a small percentage of patients, but its increased cost may prevent its general use. Thus, it should be utilized in conjunction with in-person discussions. Generally, periodic follow-up sessions are necessary to evaluate asthma control, change prescriptions, evaluate agreed-upon asthma action steps, and promote patient-provider engagement.
Conclusion
In conclusion, it is frightening to be expectant, relocate to a new place, and encounter an asthma flare-up that the individual has not had since childhood. With the correct knowledge and care, this woman can be assured that she and her child will be safe. Providing the patient with the option to participate in her medication regimen and resources to assist her in improving her therapy and comprehending her condition can make her feel at ease and demonstrate that the practitioner cares about her health and well-being. When evaluating a patient, the treatment plan, available capabilities, and interaction strategy are as crucial as the diagnosis itself.
References
Beasley, R., Harrison, T., Peterson, S., Gustafson, P., Hamblin, A., Bengtsson, T., & Fagerås, M. (2022). Evaluation of Budesonide-Formoterol for maintenance and reliever therapy among patients with poorly controlled asthma: A systematic review and meta-analysis. JAMA Network Open, 5(3), 1-12. Web.
Bonham, C. A., Patterson, K. C., & Strek, M. E. (2018). Asthma outcomes and management during pregnancy. Chest, 153(2), 515-527. Web.
Gruffydd-Jones, K., & Hansen, K. (2020). Working for better asthma control: How can we improve the dialogue between patients and healthcare professionals? Advances in Therapy, 37(1), 1-9. Web.
Labor, S., Dalbello Tir, A. M., Plavec, D., Juric, I., Roglic, M., Pavkov Vukelic, J., & Labor, M. (2018). What is safe enough-asthma in pregnancy: A review of current literature and recommendations? Asthma Research and Practice, 4(1), 1-9. Web.
Robijn, A. L., Murphy, V. E., & Gibson, P. G. (2019). Recent developments in asthma in pregnancy. Current Opinion in Pulmonary Medicine, 25(1), 11-17. Web.
Zhang, X., Lai, Z., Qiu, R., Guo, E., Li, J., Zhang, Q., & Li, N. (2021). Positive change in asthma control using therapeutic patient education in severe uncontrolled asthma: A one-year prospective study. Asthma Research and Practice, 7(1), 1-7. Web.