NR565 ASTHMA PROTOCOL: INITIAL VISIT
Name:
General Instructions:
Carefully read the assignment guidelines and rubric and complete each section of the asthma protocol
below.
1) RATIONALE
a) This protocol will assist in the differentiation between treatment needs for clients
with asthma based on age and symptom frequency and severity, including the
process for identification of clients in need of referral to pulmonology to improve
asthma control. The design of the protocol for asthma encompasses these principles.
2) SYMPTOMS
a) ASTHMA
i) History of respiratory symptoms that vary over time with varying intensity, including:
(1) Wheezing
(2) Shortness of breath
(3) Chest tightness
(4) Cough
ii) Triggers for exacerbation can include:
(1) Exercise
(2) Allergens
(3) Season changes
(4) Laughter
(5) Respiratory illness
iii) Presence of asthma phenotypes
iv) Client responses on the Asthma Control Test (ACT) or the Asthma
Control Questionnaire (ACQ)
, v) Reduced lung function and responsiveness with medications
(1) Reduced expiratory airflow (forced expiratory volume in one second, a.k.a. FEV1)
(2) Variable peak expiratory flow (PEF)
3) PHYSICAL EXAM
a) Perform the following examinations:
i) Vital Signs (blood pressure, pulse, oxygenation, respiratory rate)
ii) Auscultation for wheezing
iii) Identify increased work of breathing
iv) Identify retractions
v) Cardiac assessment
vi) Lower extremities for edema and pulses
vii) Neurological
b) Consult supervising physician if findings of:
i) Respiratory distress
4) LAB TESTS
a) Depending on severity, can include:
i) Arterial or venous blood gas
(1) ph
(2) O2
(3) CO2
(4) Bicarbonate
(5) Base excess
ii) CBC
(1) Hemoglobin and hematocrit
(2) WBC and eosinophils
iii) Total or specific IgE levels
iv) Consult supervising physician if:
(1) Abnormal blood gas results or severe anemia
Name:
General Instructions:
Carefully read the assignment guidelines and rubric and complete each section of the asthma protocol
below.
1) RATIONALE
a) This protocol will assist in the differentiation between treatment needs for clients
with asthma based on age and symptom frequency and severity, including the
process for identification of clients in need of referral to pulmonology to improve
asthma control. The design of the protocol for asthma encompasses these principles.
2) SYMPTOMS
a) ASTHMA
i) History of respiratory symptoms that vary over time with varying intensity, including:
(1) Wheezing
(2) Shortness of breath
(3) Chest tightness
(4) Cough
ii) Triggers for exacerbation can include:
(1) Exercise
(2) Allergens
(3) Season changes
(4) Laughter
(5) Respiratory illness
iii) Presence of asthma phenotypes
iv) Client responses on the Asthma Control Test (ACT) or the Asthma
Control Questionnaire (ACQ)
, v) Reduced lung function and responsiveness with medications
(1) Reduced expiratory airflow (forced expiratory volume in one second, a.k.a. FEV1)
(2) Variable peak expiratory flow (PEF)
3) PHYSICAL EXAM
a) Perform the following examinations:
i) Vital Signs (blood pressure, pulse, oxygenation, respiratory rate)
ii) Auscultation for wheezing
iii) Identify increased work of breathing
iv) Identify retractions
v) Cardiac assessment
vi) Lower extremities for edema and pulses
vii) Neurological
b) Consult supervising physician if findings of:
i) Respiratory distress
4) LAB TESTS
a) Depending on severity, can include:
i) Arterial or venous blood gas
(1) ph
(2) O2
(3) CO2
(4) Bicarbonate
(5) Base excess
ii) CBC
(1) Hemoglobin and hematocrit
(2) WBC and eosinophils
iii) Total or specific IgE levels
iv) Consult supervising physician if:
(1) Abnormal blood gas results or severe anemia
