Week 6 Assignment: Epidemiological Analysis: Chronic Health Problem

Week 6 Assignment: Epidemiological Analysis: Chronic Health Problem

Week 6 Assignment: Epidemiological Analysis: Chronic Health Problem

The Chronic Health paper is a comprehensive paper and should include content from Weeks 1-6. The headings for the paper should directly correspond to the rubric sections. The textbook is an important source for definitions and content as are scholarly websites and scholarly and research articles. Textbook: Cupp, A.L. (2020). Population-based nursing: Concepts and competencies for advanced practice. (3rd ed.). Springer Publishing Company. Be sure to include data in this paper. The data should be throughout the paper and should speak to the chronic health issue, (Asthma). The data should reflect the United States. In this paper you create a table, it is not a table copied/pasted from another source. It is formatted per APA and as such is not in color.
Week 6: Epidemiological Analysis: Chronic Health Problem
Due Sunday by 11:59pm Points 200 Submitting a file upload

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Purpose
The purpose of this assignment is:

Integrate knowledge and skills learned throughout NR503 course

Direct application of course objectives utilizing epidemiological analysis of a chronic health problem, along with state and national level data.

Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to:

See weekly outcomes from Weeks 1-6.

Due Date: Sunday, 11:59 p.m. MT at the end of Week 6.
Total Points Possible: 200
Requirements:
This paper should clearly and comprehensively discuss a chronic health disease. Select a topic from the list provided by your course faculty.

The paper should be organized into the following sections:

Introduction (Identification of the problem) with a clear presentation of the problem as well as the significance and a scholarly overview of the paper’s content. No heading is used for the Introduction per APA current edition.

Background and Significance of the disease, to include: Definition, description, signs and symptoms. Incidence and prevalence of statistics by state with a comparison to national statistics pertaining to the disease. If after a search of the library and scholarly data bases, you are unable to find statistics for your home state, or other states, consider this a gap in the data and state as much in the body of the paper. For instance, you may state something like, “After an exhausting search of the scholarly data bases, this writer is unable to locate incidence and/or prevalence data for the state of …. This indicates a gap in surveillance that will be included in the “Plan” section of this paper.

Surveillance and Reporting: Current surveillance methods and mandated reporting processes as related to the chronic health condition chosen should be specific.
Epidemiological Analysis: Conduct a descriptive epidemiology analysis of the health condition. Be sure to include all of the 5 W’s: What, Who, Where, When, Why. Use details associated with all of the W’s, such as the “Who” which should include an analysis of the determinants of health. Include costs (both financial and social) associated with the disease or problem.
Screening and Guidelines: Review how the disease is diagnosed and current national standards (guidelines). Pick one screening test (review Week 2 Discussion Board) and review its sensitivity, specificity, predictive value, and cost.
Plan: Integrating evidence, provide a plan of how a nurse practitioner will address this chronic health condition after graduation. Provide three specific interventions that are based on the evidence and include how you will measure outcomes (how will you know that the interventions have utility, are useful?) Note:  Consider primary, secondary, and tertiary interventions as well as the integration of health policy advocacy efforts. All interventions should be based on evidence – connected to a resource such as a scholarly piece of research.
Summary/Conclusion: Conclude in a clear manner with a brief overview of the keys points from each section of the paper utilizing integration of resources.
The paper should be formatted and organized into the following sections which focus on the chosen chronic health condition.
Adhere to all paper preparation guidelines (see below).
Preparing the Paper:
Page length: 7-10 pages, excluding title page and references.
APA format current edition
Include scholarly in-text references throughout and a reference list.
Include at least one table that the student creates to present information. Please refer to the “Requirements” or rubric for further details. APA formatting required.
Length: Papers not adhering to the page length may be subject to either (but not both) of the following at the discretion of the course faculty: 1.  Your paper may be returned to you for editing to meet the length guidelines, or, 2. Your faculty may deduct up to five (5) points from the final grade.

Week 6: Epidemiological Analysis: Chronic Health Problem

Start Assignment

• Due Sunday by 11:59pm
• Points 200
• Submitting a file upload

Purpose

The purpose of this assignment is:

1. Integrate knowledge and skills learned throughout NR503 course
2. Direct application of course objectives utilizing epidemiological analysis of a chronic health problem, along with state and national level data.

Activity Learning Outcomes

Through this assignment, the student will demonstrate the ability to:

See weekly outcomes from Weeks 1-6. 

Due Date: Sunday, 11:59 p.m. MT at the end of Week 6.

Total Points Possible: 200

Requirements:

This paper should clearly and comprehensively discuss a chronic health disease.  Select a topic from the list provided by your course faculty.

The paper should be organized into the following sections:

1. Introduction(Identification of the problem) with a clear presentation of the problem as well as the significance and a scholarly overview of the paper’s content. No heading is used for the Introduction per APA current edition.
2. Background and Significanceof the disease, to include:  Definition, description, signs and symptoms.  Incidence and prevalence of statistics by state with a comparison to national statistics pertaining to the disease.  If after a search of the library and scholarly data bases, you are unable to find statistics for your home state, or other states, consider this a gap in the data and state as much in the body of the paper. For instance, you may state something like, “After an exhausting search of the scholarly data bases, this writer is unable to locate incidence and/or prevalence data for the state of ….  This indicates a gap in surveillance that will be included in the “Plan” section of this paper.
3. Surveillance and Reporting:Current surveillance methods and mandated reporting processes as related to the chronic health condition chosen should be specific.
4. Epidemiological Analysis:  Conduct a descriptive epidemiology analysis of the health condition. Be sure to include all of the 5 W’s:  What, Who, Where, When, Why.  Use details associated with all of the W’s, such as the “Who” which should include an analysis of the determinants of health.  Include costs (both financial and social) associated with the disease or problem.
5. Screening and Guidelines:  Review how the disease is diagnosed and current national standards (guidelines).  Pick one screening test (review Week 2 Discussion Board) and review its sensitivity, specificity, predictive value, and cost.
6. Plan:  Integrating evidence, provide a plan of how a nurse practitioner will address this chronic health condition after graduation.  Provide three specific interventions that are based on the evidence and include how you will measure outcomes (how will you know that the interventions have utility, are useful?)  Note:  Consider primary, secondary, and tertiary interventions as well as the integration of health policy advocacy efforts.  All interventions should be based on evidence – connected to a resource such as a scholarly piece of research.
7. Summary/Conclusion: Conclude in a clear manner with a brief overview of the keys points from each sectionof the paper utilizing integration of resources.
8. The paper should be formatted and organized into the following sections which focus on the chosen chronic health condition.
9. Adhere to all paper preparation guidelines (see below).

Preparing the Paper:

1. Page length: 7-10 pages, excluding title page and references.
2. APA format current edition
3. Include scholarly in-text references throughout and a reference list.
4. Include at least one table that the student creates to present information. Please refer to the “Requirements” or rubric for further details.  APA formatting required.
5. Length: Papers not adhering to the page length may be subject to either (but not both) of the following at the discretion of the course faculty: 1.  Your paper may be returned to you for editing to meet the length guidelines, or, 2. Your faculty may deduct up to five (5) points from the final grade.
6. Adhere to the Chamberlain College of Nursing academic policy on integrity as it pertains to the submission of original work for assignments.

ASSIGNMENT CONTENT Category Pts % Description Identification of the Health Problem 15 7.5% Comprehensively and succinctly states the problem/concern. Clear presentation of the problem as well as the significance with a scholarly overview of the paper’s content. Background and Significance of the Health Problem 30   Background and significance is complete, presents risks, disease impact and includes a review of incidence and prevalence of the disease within the student’s state compared to national data. Evidence supports background. If the student discovers a gap in data (no state level data), this is stated within the section. A student created table is included using APA format.  In the case of a gap in data the student will select two other sets of data to use in the student created table. Current Surveillance and Reporting Methods  30 15% Current state and national disease surveillance methods are reviewed along with currently gathered types of statistics and information on whether the disease is mandated for reporting.  Supported by evidence. Descriptive Epidemiological Analysis of Health Problem  35 17% Comprehensive review and analysis of descriptive epidemiological points for the chronic health problem.  The 5 W’s of epidemiological analysis should be fully identified. Supported by scholarly evidence. Screening, Diagnosis, Guidelines 30 15% Review of current guidelines for screening and diagnosis. Screening tool statistics related to validity, predictive value, and reliability of screening tests are presented. Plan of Action 30 15% Integrating evidence, provide a plan of how a nurse practitioner will address this chronic health condition after graduation.  Provide three specific interventions that are based on the evidence and include how you will measure outcomes (how will you know that the interventions have utility, are useful?)  Note:  Consider primary, secondary, and tertiary interventions as well as the integration of health policy advocacy efforts.  All interventions should be based on evidence – connected to a resource such as a scholarly piece of research. Conclusion 15 7.5% The conclusion thoroughly, clearly, succinctly, and logically presents major points of the paper with clear direction for action.  Includes scholarly references   185 92% Total CONTENT Points=185 pts ASSIGNMENT FORMAT Category Points % Description APA current ed. 10 5% APA is consistently utilized according to the current edition throughout the paper. Grammar, Syntax, Spelling 5 3% The paper is free from grammar, unscholarly context or “voice” and spelling is accurate throughout.   15 8% Total FORMAT Points=15 pts   200 100% ASSIGNMENT TOTAL=200 points

Rubric

NR503_Week 6 Chronic Health_Sept19

NR503_Week 6 Chronic Health_Sept19
Criteria	Ratings	Pts
This criterion is linked to a Learning OutcomeAssignment Content Possible Points = 185 Points Introduction of Healthcare Problem/Concern	15 pts Excellent Comprehensively and succinctly states the problem/concern. Clear presentation of the problem as well as the significance with a scholarly overview of the paper’s content. 14 pts V. Good Identifies the problem/concern with adequate but not in-depth presentation. 12 pts Satisfactory Identification of problem/concern is limited. 8 pts Needs Improvement Improvement- Identification of problem/concern is unclear. 0 pts Unsatisfactory Improvement- Identification of problem/concern is unclear.	15 pts
This criterion is linked to a Learning OutcomeBackground/Significance	30 pts Excellent Background and significance is complete, presents risks, disease impact and includes a review of incidence and prevalence of the disease within the student’s state (or other data sets) compared to national data. Evidence supports background. A student created table is included. 27 pts V. Good Background is complete, presents risk, disease impact and at least one set of incidence and prevalence statistics supported by evidence, for instance state data or national data is presented, but not both. Or, full data is presented but student table is not included. 26 pts Satisfactory Background missing one or more key points and at least one set of incidence and prevalence statistics are presented. Lack of evidence or limited presentation of the background. A table is included which may or may not be student created; may be limited in data. 15 pts Needs Improvement Background missing more than one key point and at least one set of incidence and prevalence statistics are presented, or there is no supported evidence. Unclear conclusions or presentation. No student created table is included; or if included is limited in scope or is not student created. 0 pts Unsatisfactory Background and significance of the disease is not provided.	30 pts
This criterion is linked to a Learning OutcomeSurveillance and Reporting	30 pts Excellent Current state and national disease surveillance methods are reviewed along with currently gathered types of statistics and information on whether the disease is mandated for reporting. All writing is supported by evidence. 27 pts V. Good State and national disease surveillance methods are reviewed, currently gathered types of statistics is scant, reporting requirements discussed. All writing is supported by evidence. 26 pts Satisfactory State or national surveillance statistics are discussed as an overview, lacking detail / depth. Mandated reporting may be absent. Writing is supported by evidence but may be inconsistent. 15 pts Needs Improvement One of either state or national disease surveillance methods reviewed; currently gathered types of statistics may be missing or information on whether the disease is mandated for reporting is missing. There is a lack of depth with inconsistent use of evidence. 0 pts Unsatisfactory Content not discussed.	30 pts
This criterion is linked to a Learning OutcomeDescriptive Epidemiology	35 pts Excellent Comprehensive review and analysis of descriptive epidemiological points for the chronic health problem. The 5 W’s of epidemiological analysis should be fully identified. Supported by scholarly evidence. 32 pts V. Good Review and analysis has depth in general but may be missing one of the 5 W’s OR may be scant in one area of the 5 W’s. All writing is supported by evidence. 29 pts Satisfactory Review and analysis superficial in all of the 5 W’s OR may be scant or missing 2 or more of the W’s. Evidence is present but may not be throughout all content areas. 18 pts Needs Improvement Review and analysis is missing depth throughout all of the content areas. Evidence may or may not support the writing. 0 pts Unsatisfactory No analysis provided.	35 pts
This criterion is linked to a Learning OutcomeScreening, Diagnosis, Guidelines	30 pts Excellent Comprehensive review of current guidelines for screening and diagnosis. Screening tool statistics related to validity, predictive value, and reliability of screening tests are presented. 27 pts V. Good Adequate review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests is presented. 26 pts Satisfactory Limited review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests. 15 pts Needs Improvement Minimal or unclear review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests. There is a lack of depth with inconsistent use of evidence. 0 pts Unsatisfactory Review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests not provided.	30 pts
This criterion is linked to a Learning OutcomePlan	30 pts Excellent Integrating evidence, provide a plan of how a nurse practitioner will address this chronic health condition after graduation. Provide three specific interventions that are based on the evidence and include how you will measure outcomes (how will you know that the interventions have utility, are useful?) Note:  Consider primary, secondary, and tertiary interventions as well as the integration of health policy advocacy efforts. All interventions should be based on evidence – connected to a resource such as a scholarly piece of research. 27 pts V. Good An adequate, but not fully comprehensive, plan of action specific to the problem, and the geographic area is presented with 3 evidenced based actions that will be taken to address the impact, outcomes, or prevalence of the disease. 26 pts Satisfactory A limited plan of action specific to the problem, and the geographic area, outcomes, or prevalence of the disease. Three actions or less may be presented with limited or little evidence. 15 pts Needs Improvement Minimal or unclear review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests. Actions are minimal or unclear, or lack specificity, are not supported directly by evidence or are not direct actions the student can take in practice. There is a lack of depth with inconsistent use of evidence. 0 pts Unsatisfactory Plan of action not provided.	30 pts
This criterion is linked to a Learning OutcomeSummary/Conclusion = 185 Points	15 pts Excellent The conclusion thoroughly, clearly, succinctly, and logically presents major points of the paper with clear direction for action. Includes scholarly references. 14 pts V. Good The conclusion adequately and logically presents major points of the paper with clear direction for action, but lacks one major point or is not succinct. Includes scholarly references. 12 pts Satisfactory The conclusion is a limited review of key points of the paper, is not succinct, or lacks one or more major points of the paper or clear direction for action. Scholarly references may or may not be included. 8 pts Needs Improvement Conclusion is unclear or significantly limited in overview of the paper. Scholarly references may or may not be included. 0 pts Unsatisfactory No Summary/conclusion is included.	15 pts
This criterion is linked to a Learning OutcomeAssignment Format Possible Points =15 Points APA 7th ed.	10 pts Excellent APA is consistently utilized according to the 7th edition throughout the paper. 9 pts V. Good One or two errors in APA format 8 pts Satisfactory Three-Five errors in APA format 5 pts Needs Improvement Six errors in APA format 0 pts Unsatisfactory Greater than six errors in APA formatting.	10 pts
This criterion is linked to a Learning OutcomeGrammar, Syntax, Spelling	5 pts Excellent There are no grammar, unscholarly context or “voice” errors in the paper and spelling is accurate throughout. 4 pts V. Good One or two errors 3 pts Satisfactory Three-five errors 2 pts Needs Improvement Six errors 0 pts Unsatisfactory Greater than six errors	5 pts
This criterion is linked to a Learning OutcomeLate penalty deductions Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.	0 pts Minus Points 0 pts Minus Points	0 pts
Total Points: 200

A Sample Of This Assignment Written By One Of Our Top-rated Writers

 Epidemiological Analysis: Chronic Health Problem

Asthma is a respiratory disease categorized under chronic airflow limitation lung diseases. It is a chronic disorder characterized by reversible airflow obstruction in the airways that occurs intermittently (Dharmage et al., 2019). Asthma creates a significant health burden to patients and the healthcare system due to the morbidity and mortality rates associated with the disease process. The purpose of this paper is to explore asthma, including its significance, surveillance and reporting interventions, epidemiology, and screening and guidelines. It will also include a plan of how the NP can address the health condition.

Background and Significance of the Health Problem

Asthma differs from other obstructive lung diseases because it is mainly reversible, spontaneously, or with treatment patients. Thus, with asthma, a patient may experience symptom-free periods alternating with acute exacerbations, which last from minutes to hours or days. Asthma is characterized by airway obstruction, which occurs in two ways: inflammation and airway hyperresponsiveness, which results in bronchoconstriction. The inflammation blocks the lumen of the airways (Dharmage et al., 2019). On the other hand, airway hyperresponsiveness and constriction of bronchial smooth muscle results in the narrowing of the airway from the outside. Airway inflammation causes bronchiolar hyperresponsiveness, and most patients with asthma experience both inflammation and airway hyperresponsiveness simultaneously (Dharmage et al., 2019). It is worth noting that, severe airway obstruction can be fatal.

Signs and Symptoms

The three classic symptoms of asthma are cough, dyspnea, and wheezing. Acute exacerbations often occur at night or early in the morning, probably due to circadian variations that influence airway receptor thresholds. A patient with mild to moderate asthma may exhibit no clinical symptoms between asthma attacks. During an exacerbation, the most common symptoms include an audible wheeze and increased respiratory rate (Dharmage et al., 2019). Initially, the wheeze is louder during exhalation and coughing increases when inflammation occurs with asthma. The obstruction in breathing results in using accessory muscles to aid breathing during an asthma attack.

On physical exam, the patient has muscle retraction at the sternum, the suprasternal notch, and between the ribs. A patient with long-standing, severe asthma often has a “barrel chest,” attributed to air trapping. Besides, they have an increased anteroposterior (AP) diameter caused by air trapping, which results in the chest having a rounded instead of an oval shape (Dharmage et al., 2019). Patients with severe, chronic asthma may have an AP diameter that equals or exceed the lateral diameter.

Incidence and Prevalence in Arkansas

Arkansas is ranked 18^th in the prevalence of asthma, with a prevalence rate of 9.1%, slightly lower than the national rate of 9.6% as per the CDC Behavioral Risk Factor Surveillance System. The prevalence is highest among adults above 65 years with 9.8%, followed by 45-64 years at 9.6%, and 18-44 years come third at 8.4% (America’s Health Rankings, 2021). The asthma prevalence among adults above 65 years is above the national average of 8.3%. In addition, the rate is higher among females at 11.5% compared to males at 6.5%. Furthermore, the prevalence in AR is highest among multiracial groups at 14.9%, followed by Blacks at 11.5%, and Whites have the least at 9.2%.

Statistic	Arkansas	United States
Prevalence rate	9.1%	9.6%
65 years and above	9.8%	8.3%
45-64 years	9.6%	9.7%
18-44 years	8.4%	9.2%
Females	11.5%	11.8%
Males	6.5%	6.5%
Multiracial	14.9%	14.8%
Black	11.5%	11.4%
White	9.2%	9.4%

 

Surveillance and Reporting

            Asthma is not a reportable disease in Arkansas, and healthcare providers are not mandated to report patients diagnosed with asthma. However, the AR state department of health uses the Behavioral Risk Factor Surveillance System (BRFSS), a phone survey used to obtain data about the health of Arkansan adults aged 18 years and above. BRFSS is the largest telephone health survey in the state and is a vital tool for assessing adult health behaviors (Arkansas Department of Health., n.d.). BRFSS randomly chooses adults 18 years and older living in Arkansas. Adults, including those with Asthma, are identified via a random generation of home telephone numbers through a computer program to select households (Arkansas Department of Health., n.d.). BRFSS gathers data on personal behaviors like alcohol consumption, smoking, physical exercise, weight management, and preventive medical care connected to the leading causes of mortality like heart disease, asthma, cancer, diabetes, stroke, and injury.

Descriptive Epidemiological Analysis of Health Problem  

What

            Asthma is a major non-communicable disease (NCD) affecting children and adults. It has high morbidity and relatively low mortality than other chronic illnesses. Besides, asthma is the most prevalent chronic health condition among children. Asthma affects 5-10% of the US population, or approximately 23.4 million persons, including 7 million children (CDC, 2022).It affects approximately 300 million persons globally. The World Health Organization (WHO) projects that 15 million disability-adjusted life years are lost and 250,000 asthma mortalities are reported each year globally. Despite asthma being prevalent among children, disease-related mortalities are five times higher among adults than children, with adults above 65 years having the highest asthma-related mortalities. 

Who

            According to the CDC Behavioral Risk Factor Surveillance System (2020), the prevalence of asthma among adults is higher among females than males. Besides, the prevalence is higher among adults aged 18-64 than those aged 65 and older. Its prevalence is high in the extremes of age (very young and very old) due to airway responsiveness and reduced levels of lung function (CDC, 2022). Approximately two-thirds of asthma cases are diagnosed before 18 years. However, about half of all children diagnosed with asthma have a reduced symptoms by early adulthood.

            Concerning ethnic/racial groups, asthma is more prevalent among Multiracial, Hawaiian/Pacific Islander American, and Indian/Alaska Native adults than Asian adults. In addition, asthma morbidity and mortality are higher in blacks than in whites which are associated with social determinants of health (SDOH). Besides, increased asthma-associated lung function deficits have been reported in Hispanics, particularly females (CDC, 2022).Genetic factors play a major role in determining a person’s predisposition to asthma development, but environmental factors play a greater role than racial factors in asthma onset.

            Grant et al. (2022) established that SDOH including socioeconomic status, education, environmental exposures, housing, neighborhood environment, and health care access/quality also play a role. They are attributed to the excess burden of asthma prevalence, incidence, exacerbations, morbidity, and abnormal lung function among minority racial/ethnic populations. Nurmagambetov et al. (2018) found that persons aged 25 and above with less than a high school education and those with an annual household income below $25,000 have a higher prevalence of asthma than college graduates and those with higher income levels.

Where

            Asthma is prevalent in developed nations, including England, Australia, Canada, Germany, and New Zealand, with much of the data obtained in these countries. The prevalence rate of severe asthma in developed nations ranges from 2-10%. Enilari &Sinha (2019) found that nations with the highest incidence of asthma were Australia (21.5%), Sweden (20.2%), the UK (18.2%), Netherlands (15.3%), and Brazil (13.0%), but, the US and Canada were excluded in the study. On the other hand, the lowest rates were in China (1.4%), Bosnia-Herzegovina (1.4%), and Vietnam (1.0%). According to the study, the high prevalence in more developed nations was attributed to increased urbanization or westernized lifestyle, high obesity rates, and environmental pollution.

            Trends indicate that there will be an increase in the prevalence and morbidity of asthma, particularly in children below six years. Asia and Africa have a low asthma prevalence which is thought to be connected with environmental and lifestyle factors instead of genetic differences (Enilari & Sinha, 2019). Besides, additional hypotheses to explain lower asthma prevalence in developing countries include low rates of atopy, increased breastfeeding, large household size, and children being brought up in rural areas.

When

            Data from the National Center for Health Statistics show that the prevalence of asthma in US adults has increased over the years, from 7.3% in 2001 to 8.4% in 2010. Similar trends are evident among children. Furthermore, trends suggest rising asthma prevalence worldwide, with a projected 100 million new persons with the disease in the next decade (CDC, 2022). Various studies have also reported rising asthma rates in developing countries in Asia and Africa due to exposure to urbanization, passive smoking, and increasing population.

How   

            Asthma is attributed to modifiable and non-modifiable risk factors contributing to the disease process and airway hyperreactivity. The modifiable factors include occupational exposures, irritants, stress or emotional distress, exercise, obesity, exposure to allergens, and drug use, including aspirin, NSAIDs, and beta-blockers. Non-modifiable factors include hyperventilation, perinatal factors, and environmental changes (Saglani& Menzie-Gow, 2019). In addition, asthma is associated with other health conditions, including viral respiratory infections, Gastroesophageal reflux disease, chronic sinusitis, and rhinitis.

Screening and Guidelines

            No screening tests are available for asthma, but it is diagnosed using Pulmonary Function Tests (PFTs), which are the most accurate tests. The PFTs include Forced vital capacity (FVC), Forced expiratory volume in the first second (FEV1), and Peak expiratory flow (PEF). FVC measures the volume of air exhaled from full inspiration to full expiration (Saglani& Menzie-Gow, 2019). FEV1 measures the volume of air inhaled out as hard and fast as possible during the first second of the most forceful expiration after the greatest full inspiration. PEF is the fastest airflow rate attained at any time during expiration.

            Laboratory tests are not used to screen for asthma but guide in determining the type of asthma and the severity of breathing impairment. In addition, allergic asthma is screened through serum eosinophil count and immunoglobulin E levels. Skin prick testing and allergen-specific immunoglobulin E tests are used to assess sensitization to allergens. Allergic sensitization is performed in most children with asthma once they are over three years. Allergic sensitization is a predictor of the development of persistent asthma(Saglani & Menzie-Gow, 2019).Risk profile tools like the Asthma Predictive Index (API) are used to identify children with wheezing aged five years and below who are at risk of developing persistent asthma symptoms.

Plan of Action 

            The nurse practitioner (NP) will address asthma in clinical practice by preventing asthma attacks and drug therapy. For patients diagnosed with asthma, the NP will create a plan of action that focuses on controlling and preventing asthma exacerbation episodes, improving airflow, and alleviating symptoms. Specific interventions will include education on self-management, education on prevention of asthma exacerbations, and drug therapy (Hodkinson et al., 2020). Patient education on self-management will include allergen prevention. The NP will educate the patient to maintain a symptom and intervention diary, which will enable them to identify specific triggers of asthma symptoms, cues for imminent attacks, and individual responses to drugs. The NP will emphasize the essence of properly using their asthma action plan for any severity of asthma. Outcomes will be measured by assessing the patient’s understanding of their condition and its management.

            The NP will educate patients on preventing asthma exacerbations, including avoiding potential environmental asthma irritants like smoke, mold, dust mites, and weather changes. They will also be educated to avoid drugs that trigger asthma-like NSAIDs, aspirin, and beta blockers, and food prepared with metabisulfiteor monosodium glutamate (Hodkinson et al., 2020). In addition, the NP will educate patients on the importance of having adequate rest and sleep and alleviating stress and anxiety through relaxation techniques and coping mechanisms. Personal hygiene will be emphasized, including washing bedding with hot water to eliminate dust mites. Outcomes will be measured by evaluating the incidence of exacerbation and the patient’s knowledge level on preventive measures.

            The NP will incorporate drug therapy into the action plan. This will include pharmacologic management using the step-wise management of asthma based on severity and response to treatment. The NP will prescribe short-acting drugs like short-acting beta-agonists for patients with asthma exacerbations (Hodkinson et al., 2020). In addition, long-term therapy will be used to prevent asthma exacerbations using drugs like corticosteroids, Long-acting beta2-adrenergic agonists, and Leukotriene modifiers. The NP will measure outcomes by assessing how patients improve with specific drug therapy and their reduced need for short-acting therapy.

Conclusion

            Asthma manifests with airway obstruction caused by inflammation and airway hyperresponsiveness that leads to bronchoconstriction. This results in the classic symptoms of cough, dyspnea, and wheezing. AR has an asthma prevalence rate of 9.1%, with the highest incidence among adults 18-64 years. Asthma is more prevalent in developed nations and is associated with urbanization, exposure to smoking, air pollution, and change in exposure to environmental allergens. No reporting for asthma in Arkansas is required, but individuals with chronic illnesses like asthma are surveyed using the state’s BRFSS. The NP plan of action for asthma will focus on patient education on the appropriate implementation of an individualized asthma action plan, which encompasses drug therapy and lifestyle management strategies.

References

America’s Health Rankings. (2021). Explore asthma in Arkansas | 2021 annual report. https://www.americashealthrankings.org/explore/annual/measure/Asthma_a/state/AR

Arkansas Department of Health. (n.d.). BRFSS survey selection Arkansas Department of Health. https://www.healthy.arkansas.gov/programs-services/topics/brfss

Centers for Disease Control and Prevention. (2022, August 8). National center for health statistics. https://www.cdc.gov/nchs/index.htm

Dharmage, S. C., Perret, J. L., & Custovic, A. (2019). Epidemiology of Asthma in Children and Adults. Frontiers in Pediatrics, 7, 246. https://doi.org/10.3389/fped.2019.00246

Enilari, O., & Sinha, S. (2019). The Global Impact of Asthma in Adult Populations. Annals of Global Health, 85(1), 2. https://doi.org/10.5334/aogh.2412

Grant, T., Croce, E., & Matsui, E. C. (2022). Asthma and the social determinants of health. Annals of Allergy, Asthma &Immunology:Official Publication of the American College of Allergy, Asthma, & Immunology, 128(1), 5–11. https://doi.org/10.1016/j.anai.2021.10.002

Hodkinson, A., Bower, P., Grigoroglou, C., Zghebi, S. S., Pinnock, H., Kontopantelis, E., & Panagioti, M. (2020). Self-management interventions to reduce healthcare use and improve quality of life among patients with asthma: a systematic review and network meta-analysis. BMJ (Clinical Research ed.), 370, m2521. https://doi.org/10.1136/bmj.m2521

Nurmagambetov, T., Kuwahara, R., & Garbe, P. (2018). The economic burden of asthma in the United States, 2008–2013. Annals of the American Thoracic Society, 15(3), 348-356.https://doi.org/10.1513/AnnalsATS.201703-259OC.     

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