A patient is diagnosed with asthma. The primary care nurse practitioner (NP) prescribes an inhaled corticosteroid and an inhaled bronchodilator medication and provides education about how to use inhalers
At a follow-up visit 2 weeks later, the patient's pulmonary function tests are worse. The NP should: a. provide a detailed written asthma action plan for the patient.
b. ask the patient to describe how the medications have been used.
c. review the symptoms of an acute asthma exacerbation with the patient.
d. teach the patient to use the albuterol more often and order an oral steroid.
B
Follow-up visits present an opportunity for the NP to evaluate learning. A first step when symptoms have not improved is to ask the patient to describe what he or she does. A detailed written plan and a review of asthma symptoms are a part of education but should have been given at the initial visit along with hands-on instruction and demonstrations. Until it is determined whether or not the patient understands and follows the prescribed regimen, it is not correct to change the plan of care.
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