Answer all questions completely. Subheadings are mandatory and must be use to specifically separate all information. Completely evolved the paper fully. All information needs to be specific to the paper topic. No references can be used that are greater than 5 years old (2009 to 2015).All information must be from nursing or medical scholarly reputable sources that are peer-reviewed or evidence-based. Absolutely no websites such as Wikipedia, Medscape, etc…. can be used. All information needs to be specific to the topic. This paper is to be developed in APA 6th edition format/style. This information is for my case study for my class. Ensure that the instructions below are followed and developed and explained completely. Ensure you address every aspect on the instructions. I am a nurse practitioner student this case study has to be and is mandatory that it is developed and formulated from a nurse practitioner’s perspective. It is mandatory that you use NIH guidelines, for management of asthma during pregnancy as one of the references.

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.