Final answer:
The nurse practitioner should add a long-term control medication to the girl's asthma treatment plan. Based on the provided choices, the best option is to add Fluticasone (Flovent), which is an inhaled corticosteroid effective for long-term control of mild persistent asthma.
Step-by-step explanation:
A 12-year-old girl with asthma experiences daytime symptoms more than two days per week but not daily, and awakens from sleep due to asthma three to four times per month. Although her FEV1 is greater than 80%, indicating adequate pulmonary function, her symptoms suggest she has mild persistent asthma. Currently, she has been prescribed albuterol (Ventolin), which is a short-term, fast-acting bronchodilator that helps to relieve acute symptoms of asthma. However, based on her symptoms, additional long-term control medication is warranted to provide better control and prevent future asthma attacks.
Given the frequency of her symptoms, the appropriate step would be to add a long-term control medication such as an inhaled corticosteroid. Therefore, the best option among the provided choices is:
b. Add Fluticasone (Flovent)
Inhaled corticosteroids, like fluticasone, are generally considered the most effective treatment for long-term control of asthma. They help reduce inflammation in the airways and decrease the frequency and severity of asthma attacks when used regularly. Other medications like salmeterol should not be used as monotherapy for asthma and montelukast could be an option, but inhaled corticosteroids are usually preferred as first-line therapy for persistent asthma.