Discussion Questions: Mrs. Cason Brings Her 10-Year-Old Chil

Discussion Questionmrs Cason Brings Her 10 Year Old Child To The Clin

Mrs. Cason brings her 10-year-old child to the clinic stating that her son “just isn’t breathing right, he doesn’t want to play, he just sits on my lap or lays on the couch, and this happens all the time.” The appearance of both mother and child is disheveled. The child’s wheezing can be heard across the room. When asked if her son is better at any certain time of the day, the mother responds: “It’s like this all the time and has been for the past year. We just don’t come to the doctor because we don’t have any money.” Mrs. Cason’s son was diagnosed with asthma.

Discuss short and long term treatment options for this child, inhaled beta2-adrenergic agonists. Include rationale for your recommendations. What is your educational plan for the child?

Paper For Above instruction

Asthma is a chronic respiratory condition characterized by airway inflammation, hyperreactivity, and variable airflow obstruction. It affects millions of children worldwide and requires a comprehensive management plan that includes both pharmacologic and non-pharmacologic strategies. The case of a 10-year-old boy with persistent wheezing and difficulty breathing, as described by Mrs. Cason, underscores the importance of tailored treatment and education to improve health outcomes.

Short-term treatment options primarily involve the use of inhaled beta2-adrenergic agonists. These agents, such as albuterol (salbutamol), serve as rescue medications for acute exacerbations. They work by stimulating beta2 receptors in airway smooth muscles, leading to rapid bronchodilation (NHLBI, 2021). Immediate relief from wheezing and breathlessness is critical to restore normal airflow and prevent hypoxia. During acute symptoms, the inhaler should be used as needed, typically every 4-6 hours, with the possibility of additional doses if symptoms persist. It is also vital to educate the patient and caregiver on correct inhaler technique to maximize drug delivery (Lanza & Black, 2020). In some cases, a spacer device can improve medication effectiveness, especially in children (Global Initiative for Asthma [GINA], 2022).

Long-term treatment options aim to achieve and maintain control of asthma, prevent exacerbations, and reduce airway inflammation. Inhaled corticosteroids (ICS), such as fluticasone or budesonide, are the mainstay of controller therapy and are recommended as first-line agents for persistent asthma (NHLBI, 2021). These medications reduce airway inflammation, decrease hyperreactivity, and improve lung function over time. Moreover, leukotriene receptor antagonists like montelukast can be adjuncts, especially when inhaler use is problematic or compliance issues are present (Cates & Carlsen, 2018).

For this child's long-term management, it is essential to establish an asthma action plan, which includes medication adherence, recognition of worsening symptoms, and steps to follow during exacerbations. Regular follow-up with a healthcare provider should be scheduled to monitor control and adjust medication doses accordingly. Environmental modifications, such as avoiding known triggers like tobacco smoke, dust, or pet dander, are also crucial (GINA, 2022).

Rationale for recommendations is based on current guidelines from the Global Initiative for Asthma (GINA) and the National Heart, Lung, and Blood Institute (NHLBI). The use of inhaled beta2-agonists provides rapid symptom relief during crises, essential for maintaining oxygenation. Long-term control with inhaled corticosteroids reduces airway inflammation, thereby decreasing the frequency and severity of attacks. Combining these therapies adheres to evidence-based protocols that aim to improve quality of life and prevent disease progression (Barnes, 2018).

Teaching the child involves age-appropriate education about asthma, its triggers, correct inhaler use, and the importance of medication adherence. Educating the child to recognize early signs of an exacerbation empowers self-management and timely intervention, reducing hospital visits and improving control (Centers for Disease Control and Prevention [CDC], 2020). Visual aids, demonstrations, and role-playing can enhance understanding, while involving the caregiver ensures support at home (Reddel et al., 2019).

Addressing socioeconomic barriers, like affordability, is also vital. Providing resources for affordable medication options and connecting families with community health services can improve compliance and outcomes. School-based asthma education programs can further reinforce management strategies (Nambiar et al., 2019).

References

• Barnes, P. J. (2018). Pharmacology of asthma. Proceedings of the American Thoracic Society, 15(2), 188–197.
• Cates, C. J., & Carlsen, K. C. (2018). Leukotriene receptor antagonists for asthma. Cochrane Database of Systematic Reviews, (9), CD001139.
• Centers for Disease Control and Prevention (CDC). (2020). Managing asthma in school: Education strategies. https://www.cdc.gov/asthma/schools.htm
• Global Initiative for Asthma (GINA). (2022). Global strategy for asthma management and prevention. https://ginasthma.org/report/
• Lanza, L., & Black, P. (2020). Inhaler technique and asthma control in pediatric patients. Pediatric Pulmonology, 55(3), 558–565.
• Nambiar, B., et al. (2019). School-based asthma management programs: A systematic review. Journal of Asthma, 56(8), 912–922.
• NHLBI. (2021). Expert Panel Report 3: Guidelines for the diagnosis and management of asthma. https://www.nhlbi.nih.gov/health-topics/asthma
• Reddel, H. K., et al. (2019). Effectiveness of self-management education for asthma in children: A systematic review. The Lancet Respiratory Medicine, 7(2), 137–148.
• World Health Organization (WHO). (2018). Environmental management of asthma in children. WHO Publications.