Ouiser Boudreaux is a 12-year old female who comes into the office with complaints of difficulty breathing and wheezing that started during soccer practice. Ouiser’s mother reports that her symptoms occurred since starting soccer couple months ago. During the night, she wakes up 2-3 times a week due to coughing and has daily symptoms during soccer practice, causing her to sit out at least once or twice during every game. The past 2 weeks, she has also had a persistent cough and purulent sputum. Other than frequent upper respiratory infections in the fall and winter, requiring visits to urgent care, Ouiser has no significant past medical history. Penicillin and doxycycline give her a rash, and her mother reports diarrhea and abdominal pain when …show more content…
Comparison of Ouiser’s asthma symptoms to the asthma severity components listed in the table, lead to her asthma treatment step. This includes asthma symptoms, nighttime wakening, inhaled short-acting beta2 - agonist (SABAs) use for symptom control, the degree of interference of normal activity, and lung function (U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute, 2007). Ouiser’s mother reports that she has daily symptoms during soccer practice, placing her in the “persistent asthma” category. The number of nighttime wakening of 2-3 times a week, places her in the “moderate” category of “persistent asthma.” While Ouiser has never used SABAs for symptom control, her symptoms required her to sit out of her soccer games at least once or twice a game, limiting her time on the field, placing her at “Step 3” for her treatment course. The preferred treatment plan for “Step 3” is the use of medium-dose inhaled glucocorticoids (IGC) along with as-needed quick-relief medication such as SABAs for all patients (U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute,