Asthma management, Part II: Pharmacologic management.

Part I of this two-part series described the pathophysiology, types, and risk factors associated with asthma. The role of the school nurse in the development, implementation, and evaluation of a comprehensive asthma management plan was outlined, as was the role of the school nurse in controlling factors that precipitate asthma symptoms or exacerbations. Part II reviews specific school nursing responsibilities associated with current pharmacologic therapy for the child with asthma. Issues related to nutritional supplements as well as complementary and alternative treatments used in asthma management are covered. Other topics discussed include issues related to access of asthma medication in the school setting by the student, involvement of the school team in the care of the child with asthma, and health education strategies for children with asthma and their families.     

Asthma: an anesthetic update. Part 3.

The effective management of the patient with asthma continues to represent a significant challenge in modern anesthesia practice. The prevalence of asthma is increasing worldwide and is the most common chronic disorder among children. Classification and treatment strategies continue to evolve as new therapies emerge. Fortunately, the incidence of bronchospastic episodes under anesthesia has declined in recent years with the development of improved anesthetic drugs and techniques. A thorough understanding of the pathogenesis of asthma will assist in developing anesthetic management plans that are patient specific and use the best treatment pathways currently available.     

Immunization: a 1991 update. Part II.

Immunization is an important and changing area in pediatric practice. The school nurse plays a pivotal role in the ascertainment of appropriate immunization status for school children. The American Academy of Pediatrics Committee on Infectious Disease has made a number of recent substantive changes in immunization requirements for both preschool and school-age children. This article will review the salient features of those changes, especially those related to school nursing practice.     

Asthma update.

This article reviews the latest treatment of asthma and incorporates recent changes in asthma management.     

Shock, a clinical syndrome: an update. Part 3. Therapeutic management

Supportive measures attempt to improve oxygen delivery to body cells. A patent airway, adequate ventilation, and supplemental oxygen are important prerequisites. Once oxygen is delivered to the alveolar/capillary interface, it must diffuse into the blood and be carried by adequate numbers of red blood cells. Hemoglobin in the red blood cells must bind with oxygen to carry it to the tissues; yet, the hemoglobin must release the oxygen to the cells in the peripheral capillaries. Cells must be able to use oxygen to produce energy and restore normal cellular function. Restoration of cellular function is a complex sequence that cannot be achieved with a single therapeutic intervention. The supportive management of the shock patient requires many different drugs and therapies to maintain tissue perfusion and to restore normal cellular function.     

Diffuse malignant pleural mesothelioma: Part II. Symptom management

Patients with diffuse malignant pleural mesothelioma (DMPM) experience multiple symptoms from their disease and treatment, which can affect all aspects of their lives. Dyspnea, cough, pain, fatigue, depression, weight loss, anorexia, and cachexia are the most common symptoms. Early, ongoing assessment and management of these symptoms are imperative to maximize quality of life for patients with DMPM.     

Asthma management: Part 1: An overview of the problem and current trends.

Death rates from asthma have increased or remained stable over the past decade despite increased knowledge about the pathophysiology and improved treatment of the disease, a fact that is both puzzling and disconcerting. Some children with asthma experience severe and life-interfering exacerbations separated by long periods of normal lung function and no symptoms. Asthma management plans are developed by primary care providers and the family. School nurses implement and monitor the child's response to the plan. Therefore, the school nurse needs current information about asthma management. Part I of this two-part series describes the pathophysiology of asthma and the types, risk factors, and current trends in management of the disease. The role of the school nurse in asthma management is outlined, including how he or she can influence environmental factors that precipitate asthma symptoms or exacerbations. Part II will discuss the role of the school nurse in pharmacologic management of asthma. Complementary alternative medicine for asthma management will be described, as well as health teaching for the child with asthma and their family.     

Asthma update 2005: guidelines for pregnant women.

This article presents an overview of the guidelines for the management of pregnant women with asthma. Emphasis is placed on the National Asthma Education and Prevention Program guidelines.     

Type II diabetes mellitus update: diagnosis and management

Diabetes mellitus type II (currently known as non-insulin-dependent diabetes) is apparently the result of genetically imposed insulin resistance. Type II diabetes is far more common than insulin-dependent (type I) diabetes, which is probably an autoimmune disease resulting in inadequate insulin production. The decade of the '80s has seen several changes in the management of type II diabetes, including: more widespread use of glycosylated hemoglobin and home blood glucose monitoring as surveillance tools; modification of the dietary regimen by advocating increased amounts of complex carbohydrates; use in this country of the second-generation oral sulfonylureas; and therapeutic trials of tricyclic antidepressants for relief of painful diabetic neuropathy. Diabetes mellitus type II is potentially preventable through encouragement of weight loss and regular screening for those genetically at risk.