Week 4 -Assignment 1
Select one of the two questions from the discussion
questions listed below. By Week 4, Day 3, respond to the selected discussion
question and submit your response to this Discussion Area.
Be sure to respond to the question using the lessons and
vocabulary found in the reading. Justify your answers using examples and
reasoning. Support your answers with examples and research and cite your
research using APA format.
Start reviewing and responding to the postings of your
classmates as early in the week as possible. Respond to at least two of your
classmatesâ€™ posts. Participate in the discussion by asking a question,
providing a statement of clarification, providing a point of view with a
rationale, challenging an aspect of the discussion, or indicating a
relationship between two or more lines of reasoning in the discussion.
Discussion Question 1
SE is a twenty-two-year-old Caucasian woman who was
diagnosed with asthma at age seven. According to her medical record, she has
“mild persistent” asthma. Today, she reports that she has been using
her albuterol metered-dose inhaler (MDI) approximately three to four days per
week over the last two months. Over the past week, she admits to using
albuterol once daily. She has been awakened by a cough three nights during the
last month. She states she especially becomes short of breath when she
exercises. However, she also admits that the shortness of breath is not always
brought on by exercise. She also has a fluticasone MDI, which she uses
“most days of the week.” She has been hospitalized twice in the last
year for poorly controlled asthma and has been to the emergency department (ED)
three times in the last six months for the same problem. Her lab work is all
within normal limits, with the exception of a positive human chorionic
gonadotropin (HCG). Answer the following questions:
What information in the case study suggests that her asthma
is not well controlled?
What factors could possibly lead to this?
How would you classify the symptoms based upon the National
Institutes of Health (NIH) guidelines?
With the recognition that she is pregnant, how would you
alter her treatment for asthma?
Support your responses with guidelines, including the NIH
guidelines, for management of asthma during pregnancy. Use other peer-reviewed
articles as needed to support specific aspects of your plan.
Discussion Question 2
TJ is a fifty-five-year-old police officer who presents to
the clinic with complaints of epigastric pain for two weeks. He has been taking
over-the-counter (OTC) Zantac without relief. He was diagnosed about a year ago
with a bleeding ulcer, and he expresses concerns that the current symptoms
remind him of that event. At that time, he was given “multiple prescriptions”
for his stomach, but he did not complete the course of therapy because he began
to feel better. He also has osteoarthritis in his wrists and hips, for which he
takes OTC NSAIDs. He smokes one to two packs per week and drinks an average of
one alcoholic beverage daily. His vital signs and blood work are all within
normal limits. Answer the following questions:
What additional testing would you suggest at this point?
Describe any and all variables that could be contributing to
What alterations would you suggest in his treatment? Be sure
to consider additional diagnoses and whether prophylaxis would be appropriate
for NSAID-induced ulcers.
Support your responses with guidelines you locate in the
literature and peer-reviewed articles as needed to support your ideas.