1. Independent Study Mentorship By: Sergio Sanchez Mrs. Click 7 th 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 Pharmacological Therapies

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. 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. Smoking

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. Classification of Severity Mild Intermittent Symptoms < 2 days per week Or 2 nights per month Exacerbations brief Mild PersistentSymptoms > 2 times per week, but < 1 time per day Or < 2 nights per month Moderate PersistentDaily Symptoms Or more than 1 night per week Severe PersistentContinual Symptoms Or Frequent nighttime symptoms 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. Pharmacological Management << Previous Page

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. 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. Inhaled Corticosteroids (ICS)

26. Long Acting BetaAntagonist (LABA) Considered a controller medicine, 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 Amelie Hollier. 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