Determine appropriate treatment plan for Michelle. Discuss medications, doses, Durable
Medical Equipment, and any testing, and apply these directly to her case. Provide your
rationale with evidence.
Influenza infections are a respiratory disease that can trigger asthma attacks and cause worsenin...
Professor and Class,
Week 2 Part 2 Case Study
Determine appropriate treatment plan for Michelle. Discuss medications, doses, Durable
Medical Equipment, and any testing, and apply these directly to her case. Provide your
rationale with evidence.
Influenza infections are a respiratory disease that can trigger asthma attacks and cause worsening
asthma symptoms (CDC, 2019). Adults that have asthma and become infected with influenza are
more likely to develop pneumonia after getting sick with influenza than those who do not have
asthma (CDC, 2019). Treatment with antiviral medications work best when started within 48
hours after symptoms start (Gaitonde, et al., 2019). Antiviral medications work by fighting
against influenza and preventing the virus from making more viruses in the body (CDC, 2019).
Oseltamivir or Peramivir are the two antiviral medications that can be used in patients with
asthma (Gaitonde, et al., 2019). A different antiviral medication, Relenza, should not be used in
patients with asthma due to the risk of causing wheezing (CDC, 2019). Michelle your symptoms
began 2 days ago (within the 48 hour window), therefore allowing you to be a candidate for
antiviral therapy. Michelle you also have an allergy to strawberries and erythromycin. These
allergies will allow you to take Oseltamivir.
Influenza can cause a dry or productive cough, fever, muscle aches, congestion, increased
shortness of breath, or wheezing (CDC, 2019). The Infectious Disease Society of America
(IDSA) recommend that providers who have a diagnosis of influenza are discouraged to use
unnecessary antibiotics (Uyeki, et al., 2018). If a patient with confirmed influenza, such as
Michelle, does not demonstrate clinical improvement with antiviral treatment or demonstrates
clinical deterioration during or after treatment, additional testing should be considered to rule out
other infectious diseases, such as pneumonia (Uyeki, et al., 2018). Symptom relief is a goal for
those diagnosed with influenza (CDC, 2019). Staying home and getting plenty of rest, drinking
lots of fluid to avoid dehydration, and treating fever are all ways to help relief symptoms
(Kennedy-Malone, et al., 2019). NSAIDs can exacerbate symptoms of asthma and should not be
used (Kennedy-Malone, et al., 2019). Acetaminophen is a good alternative to relieve fever or
pain and does not exacerbate asthma (Kennedy-Malone, et al., 2019). Michelle, I want you to
avoid NSAIDs, such as, ibuprofen and to take acetaminophen as needed over-the-counter for
fever. Your asthma symptoms have been well-controlled with a low-dose inhaled corticosteroid
inhaler, Singulair, and Albuterol as needed. If asthma symptoms are well-controlled there is no
need to modify current treatment rather the goal is to treat the risk factor that is causing
symptoms (GINA, 2020). Spirometry and peak flow testing should be avoided unless there is an
urgent need to prevent the spread of viral particles (GINA, 2020). The appropriate test has
already been completed to confirm a diagnosis of influenza-A.
Decide whether she is safe to return home, include any prescriptions, or if a referral to a
higher level of care is required. Discuss the criteria used to make your decision, how a
referral is made and defend your position.
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