Case studyAsthma management

How would you classify the symptoms based upon the National Institutes of Health (NIH) guidelines?

The control assessment is straightforward and the case rewards doing it properly. Then there is a positive pregnancy test in the last sentence, and it changes what you prescribe.

Editorial process

Last reviewed · August 25, 2026

Written by

Maren Caldwell

MSN, RN, CNE

Medical-surgical nursing, pharmacology and NCLEX preparation

Reviewed by

Dr. Tessa Redmond

DNP, RN, CNE

Evidence-based practice and clinical education

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Interpret the task
Assignment instructions
Deliverables
Proposed outline
Research plan
Reference shortlist
Final review

Classify the control, then read the last line again

Work the control assessment from the case's own numbers rather than from impression, since the classification framework uses exactly the variables supplied. Rescue inhaler use three to four days a week rising to daily, night-time waking three times in a month, exertional and non-exertional breathlessness, two hospitalisations in a year and three emergency attendances in six months all point the same way: this is not well controlled, and the exacerbation history alone would classify it that way regardless of the symptom frequency. Note that her record says mild persistent, which is a classification made at some point in the past and has not been revisited. The gap between a recorded severity and current control is a real clinical finding, and stating it explicitly is worth doing before any of the treatment questions are answered. Her record says mild persistent, which is a classification made at some point in the past and never revisited.

Before stepping up therapy, work the causes, because the case gives you a strong candidate: she uses her fluticasone inhaler most days of the week, which means she does not use it every day, and an inhaled corticosteroid taken intermittently does not deliver the control it is prescribed for. Inhaler technique, spacer use, mouth rinsing, trigger exposure and comorbidities such as reflux and rhinitis belong in the same assessment, and none of them requires a new prescription. Then the positive HCG at the end of the laboratory line changes the plan, because asthma control matters more in pregnancy rather than less, poorly controlled asthma carries risks to the pregnancy, and the general principle is that treating asthma is safer than leaving it untreated. Say that explicitly, favour agents with the most pregnancy safety data, and address the folic acid, smoking and follow-up conversation that the finding also triggers.

Likely learning objectives

Classify asthma control from the case's own reported variables.
Recognise a recorded severity that has not been revisited.
Investigate adherence and technique before stepping up therapy.
Adjust the plan for pregnancy without under-treating asthma.

Assignment instructions

Read the full question

Review every instruction before using the planning guidance that follows.

NSG 6005 Week 4 Assignment 1 DQ 1 SE is a twenty-two-year-old Caucasian woman who was diagnosed with asthma at age seven .According to her medical record, she has “mild persistent” asthma .Today, she reports that she has been using her albuterol metered-dose inhaler (MDI) approximately three to four days per week over the last two months .Over the past week, she admits to using albuterol once daily .She has been awakened by a cough three nights during the last month .She states she especially becomes short of breath when she exercises .However, she also admits that the shortness of breath is not always brought on by exercise .She also has a fluticasone MDI, which she uses “most days of the week .” She has been hospitalized twice in the last year for poorly controlled asthma and has been to the emergency department (ED) three times in the last six months for the same problem .Her lab work is all within normal limits, with the exception of a positive human chorionic gonadotropin (HCG) .Answer the following questions: What information in the case study suggests that her asthma is not well controlled? What factors could possibly lead to this? How would you classify the symptoms based upon the National Institutes of Health (NIH) guidelines? With the recognition that she is pregnant, how would you alter her treatment for asthma? Support your responses with guidelines, including the NIH guidelines, for management of asthma during pregnancy .Use other peer-reviewed articles as needed to support specific aspects of your plan . Select one of the two questions from the discussion questions listed below .By Week 4, Day 3, respond to the selected discussion question and submit your response to this Discussion Area . Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format . Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .

Course-wide instructions that accompany this question

ADDITIONAL INSTRUCTIONS FOR THE CLASS Discussion Questions (DQ) Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. NSG 6005 Week 4 Assignment 1 DQ 1 One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses. Weekly Participation Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. APA Format and Writing Quality Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition. Use of Direct Quotes I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. LopesWrite Policy For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score. Late Policy The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. Communication Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

What the case asks

01Identification of the information in the case that suggests her asthma is not well controlled.
02The factors that could possibly lead to this.
03Classification of the symptoms using the recognised framework.
04A treatment plan appropriate to the classification and to the case findings.
05Patient education and follow-up.