Question

Mr. Mc Connell carries a diagnosis of poorly controlled asthma. The Nurse Practitioner is checking the electronic health record and notes that his usage of Albuterol is excessive. Mr. Mc Connell is going through 1 canister every 10 days. What would your first steps be and what recommendations would you give this patient ? Please explain your rationale.

Answer 1

Asthma a medical condition characterized by narrowing of airways. The common causes includes triggers that influence an asthmatic attack. The allergens like pollen,dust,mites,molds triggers asthmatic attacks. Exposure to air pollutants, recurrent respiratory infections, excercise, certain medications like non steroidal anti inflammatory drugs, beta blockers,anticoagulants like aspirin,encountering with stress,intake of cool foods and beverages also contributes to asthma.

Poorly controlled asthma is a chronic condition results when the person is not using right medication or improper usage of inhalers.

Albuterol is a drug of choice used to treat asthma. It is an oral inhalation agent to treat breathing difficulty,wheezing,chest tightness,cough. It is in the form of aerosol or powder that is inhaled using inhaler.

Excess usage of albuterol inhalation increases the risk of death. Overdose lead to certain complications like chest pain,tachycardia, dryness of mouth, nausea and convulsions.

First steps and recommendations to the patient:

- Nurse practitioner should educate the patient regarding the steps to use the inhaler in a proper way. Health education regarding inhaler usage can be teach to the patient using proper illustration and demonstration.

- Perform hand hygiene to prevent the transmision of infection.

- First patient should sit in a comfortable way . ( This facilitates proper delivery of the medication)

- Shake the inhaler well. ( This facilitates proper delivery of the medication)

- Exhale the breath through the mouth. Remove the cap in the mouthpiece.

- Insert the canister fully and firmly inside the mouth.

- Hold the canister with mouth piece facing on the bottom and canister pointing upward.Close the lips tightly over the canister.

- Slowly breath deeply through the mouth piece and press down the container to spray the content into the mouth.

- Hold the breath for 10 seconds and then remove the inhaler and breath out slowly.