[Solved]Freddie is 6 years old and has a confirmed diagnosis of asthma. He has been using his salbutamol inhaler most days recentl

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[Solved]Freddie is 6 years old and has a confirmed diagnosis of asthma. He has been using his salbutamol inhaler most days recently.

Asthma Level 5 Problem Solving Assignment (40%)

Please follow the instructions in the assignment guideline and answer the questions below.

Question 1:

Freddie is 6 years old and has a confirmed diagnosis of asthma. He has been using his salbutamol inhaler most days recently. His parents are reluctant for him to use Inhaled Corticosteroid (ICS) treatment in spite of his night time cough and symptoms with exercise.

a)     Briefly outline the pathophysiology of asthma

b)    How would you explain to Freddie’s parents the importance of regular ICS therapy? Discuss the role ICS plays in asthma treatment. You should include advice about the safety of ICS therapy, when it should be taken and potential side-effects.

c)     What are the key points you need to address when explaining to Freddie’s parents the role of Short Acting Beta Agonist’s (SABA)? Discuss the role SABA plays in asthma treatment. You should include advice about when it should be taken, how it works and the side-effects?

Question 2:

Ananya is 28 years old and has no previous history of asthma. She has recently moved to the area following her marriage and has registered with the practice. She presents complaining of an early morning cough and occasional chest tightness for several weeks. Ananya needs a structured clinical assessment for the diagnosis of asthma.

a)     What should be included when taking a history from Ananya? The relevance of the clinical questions should be discussed and related to the probability of asthma.

b)    Discuss the range of objective tests available to support the diagnosis of asthma and explore how variability and reversibility may be demonstrated.

Question 3:

Daniel is 15 years old and attends on his own for a routine annual review of his asthma. He has been prescribed an ICS and SABA via a pressurised Metered Dose Inhaler (pMDI). You observe his inhaler technique to be poor.

a)     What are the common errors patients make when using pMDI’s? You should include a discussion about inspiratory flow.

b)    What key factors should be considered when selecting an inhaler device with a teenager?

c)     Select one device which may be suitable for Daniel and discuss how you would explain its correct use. This should include detail regarding inspiratory flow rate

Question 4:

Nadia is a 48 year old teaching assistant. She had several hospital admissions for asthma in childhood but has no recent history of asthma attacks. She presents with an increase in asthma symptoms over the last few days and has noticed she is getting less relief from her SABA. She has been using this several times a day over the last few days.

a)     What are the categories of severity of asthma attacks and how would you reach the conclusion that Nadia has acute severe asthma?

b)    What treatment and management does she need immediately? 

c)     When should Nadia be followed up following this acute episode and what should be included in the consultation?