Asthma: Patient Education (Nursing)

00:00 Patient education is the most important thing you can do. Right? We want to make sure the patient understands appropriate medication. What do I take in an attack, what do I take everyday to prevent attacks? So you want to address environmental factors. So I want the patient to understand "Hey what are your triggers? What are the things that set you off? Is it dust, is it cat, or pet dander? What is your trigger? Is it a certain food? So they know they can minimize their exposure to those types of elements. Now I want them to be really good at managing their asthma. Self-management means I want you to know so much about asthma as is appropriate so you know what to do. One of the best tools they can use is PEFR. Now if you're not familiar with this, peak expiratory flow rate. Okay that's what PEFR is. So, write that out just to remind yourself, peak expiratory flow rate. That will help me measure 4-second blowout width. That will help me better assess control and adjust the therapy safely. Because the healthcare provider and the patient are going to make up a plan together based on this measurement, peak expiratory flow rate. You can do those, just a small pocket-sized monitor.

01:24 Now, let's look at this that we have here. Look, it goes in a circle. Right? Because this is ongoing. The patient will experience increased exposure to their problems, to their triggers and those type of things. There will be different seasons where they're better or worse.

01:39 Things may progress or get better so it requires constant reevaluation. But I'm going to start at the top. Look, assess and monitor asthma control. That says let's figure out, we can use a PEFR to tell us "Hey, how can we measure the peak expiratory flow rate? What is a good normal baseline for this patient when they're not in an exacerbation?" They will make sure we go over medication technique and if they know how to stick to it and assess the side effects, we'll look at what's going on in their environment so we do that with the patient. We educate them, but we also ask them very clear questions to get all this information out on the table so we know we're dealing with. Now you help them understand a step-up or stepdown in medication.

02:26 That will come in an asthma action plan that we'll talk about in just a minute. So, how do we assess and monitor how asthma control is going? We'll look at the medication techniques. Do they know how to use a metered-dose inhaler? Do they need a spacer? And what a spacer does is just a piece of plastic in between the little metered-dose inhaler and the patient's mouth. So that's a mouthpiece on this end I can put my mouth on. Has another piece that connects to the metered-dose inhaler. By squirting that into the chamber, then I can inhale it and get more of the medication into my lungs. You get significantly more medication from an an MDI into a patient's lungs by using a spacer, then you would just shooting it right into their mouth. Because sometimes when the patient uses an MDI right in their mouth, it ends up in their cheek. So they may need to use a spacer. Now that can be for adults or for other patients. Are they able to use the spacer effectively? Are they able to use the MDI effectively? Do they have the hand strength or the hand size to do it? Do they need the parents to help them? Those are the types of things we are expert at as nurses. We think through everything to make sure "Hey is this logical?" Like I know this medication will work. But does the patient can they get it, can they access it, and do they know how to use it or to administer it? Do they know when they should take more medication or less medication? We also know have they maintained their step-up or stepdown? When should they stay at that level? How long should they stay at the level? And always we schedule another follow-up appointment. Start the next process over and over and over again. See the best asthma self-management program, it involves a patient that's engaged, can give you good information, and the healthcare worker that has a great therapeutic relationship with this patient. So they can ask questions, be non-threatening, get good intel from the patient. So together the healthcare provider, the nurse, the patient and family as appropriate can make the most effective plan. Because remember our goal, we want to help the patient have fewer exacerbations. When they do have them, have them be less intense or severe and we want to minimize the damage to their lungs especially with our kiddos who are still growing strong lungs. So we talked about peak expiratory flow rate. That helps us know what is the appropriate medication to give the patient. So we look at the environmental factors that cause their symptoms to get worse, we want to teach them self-management skills, and self-monitoring. So that's peak expiratory flow rate. Okay, so in order to assess that we want to control, assess, and adjust their therapy safely.