Independent Study Mentorship

1. Independent Study Mentorship By: Sergio Sanchez Mrs. Click 7th Period Spring 2014

2. Mentor • Mrs. Amy Katherine Haverty she is Pediatric Nurse Practitioner at UTMB Health and Pediatrics & Adult Primary Care. • Mrs. Haverty graduated from Marquette University as Registered Nurse in 1994. • She spent five years as an RN on active duty with the Army • She began working as a nurse practitioner in 2007.  "Amy Katherine Haverty, PNP." UTMB Health - Amy Katherine Haverty. N.p., n.d. Web. 23 Feb. 2014.

4. Mentorship Site

6. Project Topic • An overview of Asthma and its etiology. • The signs and symptoms of asthma • Diagnosing asthma • Preventing asthma • Asthma Action Plans • Discussing its PharmacologicalTherapies

7. Epidemiology • 15 million people in the United States have Asthma, 5 million being children or adolescents. • Childhood Asthma is responsible for: • 13 million Physician visits. • 200,000 hospitalizations. • 550,000 emergency department visits. • 8 million prescriptions.

8. What is Asthma? • Asthma is a chronic lung disease characterized by 3 features. • Airway obstruction that is at least partially reversible. • Airway hyper-reactivity or hyper-responsiveness to a variety of external stimuli. • Chronic inflammation of the airway. "Asthma." Definition. Mayo Clinic Staff, 14 Feb. 2014. Web. 23 Feb. 2014.

10. Etiology • Common triggers of Asthma • Viral Respiratory Infections • Exercise • Smoking • Family History • Pets • Environmental triggers

11. Allergens • Animal Dander • Dust • Food • Mold • Cockroaches • Change in weather usually cold air • Emotional expression such as laughter or anger • Gastroesophageal Reflux Disease (GERD-Reflux)

12. Signs and Symptoms • Exacerbations • Wheezing • Retractions • Shortness of breath • Cyanosis

13. Exercise-Induced Asthma • Younger patients may experience flare ups after running or riding a bike. • Physical exam may be preformed in clinic, then medical provider checks for asthma symptoms. • Peak-Flow Meter may be used to set a base line.

14. Smoking • Breathing second-hand smoke, also known as passive smoking and is harmful to the lungs. • Tobacco smoke irritates the airways in the lungs. • No one should smoke near or in an area where a child is present. • Children who live with a smoker in the household are less likely to grow out there asthma, and more likely to need more medications and emergency room hospital visits.

15. Status Asthmaticus • A severe asthma attack that does not respond to the usual treatment. • Symptoms include extreme trouble breathing, inability to speak, bluish tinged lips, heavy sweating and unconsciousness. • Health Care providers will measure oxygen saturation levels and order the patient oxygen. • Patient is usually hospitalized and may be treated in ICU, with IV medicine and steroids.

16. Hollier, Amelie. "Asthma." Clinical Guidelines in Primary Care: A Reference and Review Book. Lafayette: Advanced PracticeEducation Associates, 2011. 588+. Print.

17. Treatment Approach • Prevent chronic and troublesome symptoms. • Maintain normal or near normal pulmonary function. • Maintain normal activity levels, including exercise. • Prevent exacerbations. • Provide optimal medical regimen.

19. Delivering Asthma Medications • Inhaler - Asthma inhalers are hand-held portable devices that deliver medication to your lungs. • Nebulizer Machine – Medication is delivered via face mask. • Spacer –Aerochamber device used to deliver medication more effectively and accurately to young children. • Spirometer– A diagnostic device that measures the amount of air you're able to breathe in and out and the time it takes you to exhale completely after you take a deep breath. • Peak Flow Meter - It measures how fast they can blow air out of their lungs.

21. << Previous Page PharmacologicalManagement

22. Pharmacologic Therapy • Short acting B-Agonists (SABA) • Albuterol nebulizer treatment or inhaler • Albuterol is used as rescue inhaler • Systemic Corticosteroids • Oral or IV steroids • Inhaled Corticosteroids • Inhalers Hollier, Amelie. "Asthma." Clinical Guidelines in Primary Care: A Reference and Review Book. Lafayette: Advanced PracticeEducation Associates, 2011. 588+. Print.

23. Short Acting Beta Antagonists (SABA) • Albuterol and Xopenex. • Quick-Relief, reliever or rescue medications. • This medicine is not intended to be used for daily. • SABAs quickly cause bronchodilation by relaxing the smooth muscle of the bronchi.

25. Inhaled Corticosteroids (ICS) • Flovent and Qvar are two of the most commonly used. • Blocks action of acetylcholine causing bronchodilation. • ICS decrease activity of inflammatory cells. • Steroid activity is local in the lungs and is associated with minimal systemic absorption. • Patient should always rinse mouth. Hollier, Amelie. "Asthma." Clinical Guidelines in Primary Care: A Reference and Review Book. Lafayette: Advanced PracticeEducation Associates, 2011. 588+. Print.

26. Long Acting BetaAntagonist(LABA) • Considered a controllermedicine, since it is taken every day. • LABAs do not give quick relief of wheezing in acute attacks. • They should never be used as the only treatment for asthma. • They are usually prescribed with an inhaled corticosteroid. Winland-Brown, Jill E., Brian O. Porter, and Debera J. Thomas. "Asthma." Primary Care The Art and Science of Advanced Practice Nursing. By Lynne M. Dunphy. 3rd ed. Philadelphia: F.A . Davis, 2011. 339+. Print.

27. Oral Steroids • Also known as systemic corticosteroids. • May be taken as a controller medicine to treat severe asthma. • Are usually prescribed for a patient to take home after an asthma flare up. • An example is Prednisone. • Patients should be reminded to take with food to prevent an upset stomach.

28. Works Cited • "Amy Katherine Haverty, PNP." UTMB Health - Amy Katherine Haverty. N.p., n.d. Web. 23 Feb. 2014. • "Asthma." Definition. Mayo Clinic Staff, 14 Feb. 2014. Web. 23 Feb. 2014. • Hensley, Rhonda. "Asthma." Clinical Guidelines In Primary Care: A Reference and Review Book. By AmelieHollier. Lafayette: Advanced Practice Education Associates, 2011.588+. Print. Advanced Practice Education Associates. • Hollier, Amelie. "Asthma." Clinical Guidelines in Primary Care: A Reference and Review Book. Lafayette: Advanced PracticeEducation Associate • Papadakis, Maxine A. "Asthma." CURRENT Medical Diagnosis & Treatment. By Stephen J. McPhee. 50th ed. United States of America: McGraw-Hill Companies, 2011. 240+. Print. • Winland-Brown, Jill E., Brian O. Porter, and Debera J. Thomas. "Asthma." Primary Care The Art and Science of Advanced Practice Nursing. By Lynne M. Dunphy. 3rd ed. Philadelphia: F.A . Davis, 2011. 339+. Print.

29. Acknowledgements • Mrs. Amy Haverty • Mrs. Click • Evaluators • Family • Friends