Based on the patient’s thorough history, the old inhalant use, and examination findings, the most likely diagnosis will be an acute exacerbation of asthma. The doctor will be able to diagnose that the current condition to date is the exacerbation of asthma since the patient had that condition when he was around eight years old, along with the present cough, wheezing, and waking up during the night. Besides, vocal wheezing of the entire lung fields on examination suggests extensive airflow limitation, most likely resulting in an asthmatic flare. This means of absenting fever, the normal oxygen saturation increasing and Vital signs, and gangs acting together to diagnose an asthma exacerbation. Medical history cannot be the only information associated with a pregnancy patient as chronic condition asthma may be influenced by hormonal changes and various effects caused by a growing uterus, which can be confirmed by evidence-based research and guidelines from such organizations as the Global Initiative for Asthma (GINA) (Couillard et al.,2021).
Treatment Plan Specifically for the Patient: Pharmacologic and Non-Pharmacologic
Pharmacological Management
The pharmacological therapy of the patient consists of starting treatment with a specific drug regimen appropriate to reduce the symptoms of exacerbated asthma. According to Zaidan et al. 2020, Albuterol, which is administered every 4-6 hours via metered dose inhaler (MDI ) with a spacer as needed, is used as a bronchodilator, quickly helping to relieve wheezing and coughing by improving acute airflow limitation. Budesonide Maldispers System, taken at 100mcg twice daily, brings a fast relieving effect and long-lasting control of inflammation. Therefore, the risk of exacerbation relapse will likely be reduced when applied consistently. The prednisone recommended a dosage of 40-60 mg only once daily for 5-7 days. It will stabilize the pace of exacerbation and facilitate the resolution of the symptoms. Symptom ratings, oxygen saturation and lung capacity levels are regularly monitored, and they make the efficacy of the medication a few steps higher, knowing that numerous tests to check the health of the fetus incorporate assessing its level of stress and anticipating outcomes for both mother and the fetus is the main aspect.
Non-Pharmacological Management
Likewise, in terms of non-pharmacological asthma management, a multimodal approach, which accounts for patients’ needs and reduces triggers through lifestyle adjustments and self-management skills, is employed to achieve better asthma control. This involves eliminating the triggering elements in the environment, like smoke, dust, and allergens, excellent ventilation, maintaining cleanliness in the living areas, and having a system to ensure minimal exposure to the substances that can irritate the respiratory system. Patient training is a vitally important step since it involves the correct inhaler placement, compliance with treatment plans, and identification of early indications of aggravation of the symptoms. Furthermore, stress management methods which practice breathing exercises and mindfulness are given so that stress factors such as psychosocial stressors are mitigated from the manifestation of asthma symptoms. Daily tracking of symptoms, peak flow meters, and an exacerbation action plan encourage patients to manage their asthma effectively. The main target of non-pharmacological management is to provide an option that depresses the impact of environment and behaviours and will work better when cooperated with pharmacotherapy for treating asthma (Cazzola et al., 2023).
Community Resources Currently Available to Support the Patient
Pregnant individuals in our community experiencing asthma attacks, evictions, and the lack of health insurance receive a collection of support services. A community health centre is an integral resource for community healthcare services, such as prenatal care and asthma management. Some centres may offer these services on a sliding scale fee or even free for uninsured individuals. In most cases, the therapeutic centres are positioned everywhere to comfort at-risk individuals and offer them shelter, counselling, legal advocacy, and referral support to other local supportive centres or resources. Furthermore, LADHS offers various social services like housing assistance and employment resources, and you are free to enrol in Medicaid and Women, Infants and Children (WIC) programs as you may prefer (Bitler et al., 2021). Community groups that provide pregnancy support offer counselling, prenatal education, material help and emotional support to parents. Moreover, free assistance from local workforce development agencies also plays a vital role in connecting people to jobs and a more stable financial situation. These community-based resources are a powerful tool in the struggle for the delivery of appropriate prenatal care and successful pregnancy outcomes for women who suffer from asthma exacerbations and social issues at the same time.
Implementing a Communication Strategy to Engage the Patient in the Treatment Plan
The patient’s treatment plan will involve a communication strategy based on therapeutic principles in which the patient will be actively engaged. Firstly, the rapport will be built by building a friendly and endearing atmosphere in which the patient can feel relaxed and share what bothers her. By asking questions and showing empathy, communication will achieve trust, which is the base for effective communication. Instruction will be the next level since fully understandable guidance, including asthma management and treatment options, will be delivered. It will be the health care provider’s responsibility to include her in the decision-making process and to ensure that she takes part in the treatment process and that the treatment she chose is aligned with her favoured options and objectives. Patients will be applauded with positive reinforcement and encouragement for their effort, progress, and milestones on the treatment plan to motivate them to continue with the treatment regime. Further, frequent check-ups and accommodating help keeping the treatment process productive will be the cornerstones of the continuing care services, resolving any issues and offering help when needed. Through this patient-centred approach, the physician can give the patient a chance to encompass the responsibility of health and the consequent lifestyle of the patient.
Utilizing National Guidelines, Pharmacology and Pathology References, and Professional Medical Sources
The medications that are now prescribed for the patient’s chronic asthma exacerbation meet the up-to-date, evidence-based guidelines and are recommended in the medical literature. Based on the Global Initiative for Asthma (GINA) recommendations, the drug treatment of asthma attacks implies, among other things, the administration of a bronchodilator method, c-glucocorticoid, e.g., budesonide, for anti-inflammatory actions (Couillard et al.,2021). These medications, as detailed in pharmacology textbooks like “Goodman and Gilman’s: Ractopamine, a selective agonist of β2-adrenoceptors, and the bronchodilator aerosol, are among the most frequently used drugs during pregnancy, and also provide necessary medication for acute airflow restriction and inflammation associated with reversible airway diseases (Khonsary, 2023). Prednisone, a calming corticosteroid, is administered to calm down the severity of the attack, allowing ease in symptom resolution, as noted in medical journals covering the asthma management topic (Arslan et al., 2023). Additionally, the masterful monitoring of symptoms, oxygen saturation, and lung function, as stipulated by major advanced practice leaders, provides a thorough evaluation of the effectiveness of pharmacological interventions and the overall well-being of the mother and fetus.
References
Arslan, B., Çetin, G. P., & Yilmaz, İ. (2023). The Role of Long-Acting Antimuscarinic Agents in the Treatment of Asthma. Journal of Aerosol Medicine and Pulmonary Drug Delivery, 36(4), 189-209.https://doi.org/10.1089/jamp.2022.0059
Bitler, M., Gennetian, L. A., Gibson-Davis, C., & Rangel, M. A. (2021). Means-tested safety net programs and Hispanic families: Evidence from Medicaid, SNAP, and WIC. The ANNALS of the American Academy of Political and Social Science, 696(1), 274-305.https://doi.org/10.1177/00027162211046591
Cazzola, M., Page, C. P., Matera, M. G., Rogliani, P., & Hanania, N. A. (2023). Revisiting asthma pharmacotherapy: where do we stand and where do we want to go?. European Respiratory Journal, 62(2).https://doi.org/10.1183/13993003.00700-2023
Couillard, S., Connolly, C., Borg, C., & Pavord, I. (2021). Asthma in pregnancy: an update. Obstetric Medicine, 14(3), 135-144.https://doi.org/10.1177/1753495X20965072
Khonsary, S. A. (2023). Goodman and Gilman’s The Pharmacological Basis of Therapeutics. Surgical Neurology International, 14.doi: 10.25259/SNI_184_2023
Zaidan, M. F., Ameredes, B. T., & Calhoun, W. J. (2020). Management of acute asthma in adults in 2020. JAMA, 323(6), 563-564. doi:10.1001/jama.2019.19987
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