prepU ch 55 Drugs Acting on the Lower Respiratory Tract

The nurse has finished teaching a 15-year-old client how to use an inhaler to treat asthma. What statement by the client suggests an understanding of the teaching?

"I need to shake the inhaler well before taking the medication."

A client with asthma has been prescribed an albuterol inhaler. What recommendation should the nurse include in client teaching?

"Stop smoking to reduce bronchoconstriction."

When evaluating an asthmatic client's knowledge of self-care, the nurse recognizes that additional instructions are needed when the client makes which of the following statements?

"When I am short of breath, I will increase the use of my fluticasone."

The nurse assesses the serum theophylline of a client. Which finding would the nurse identify as being therapeutic?

15 mcg/mL

The nurse instructs a patient who is using albuterol for exercise-induced bronchospasm to use the inhaler at which time?

15 minutes prior to exercising

A client is prescribed albuterol, 2 puffs every 6 hours. After teaching the client about the drug and its administration, the nurse determines that the teaching was successful when the client states that he will allow how much time between each puff?

3-5 minutes

A client is prescribed salmeterol as treatment for exercise-induced asthma. The nurse would instruct the client to use the inhaler at which time?

30 minutes before engaging in exercise

A patient who is prescribed ipratropium administers the drug at 9:15 AM. The patient should begin to notice the drug beginning to act at which time?

9:30 AM

The nurse is performing a routine assessment of a client whose medical record indicates a history of asthma. What assessment findings would the nurse expect? Select all that apply.

Airway inflammation Damaged airway mucosa

Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?

Albuterol causes relaxation of the bronchial smooth muscles.

The client has been diagnosed with asthma and is being treated with two inhalers, albuterol and flunisolide. The nurse teaches the client that the two medications should be administered in what order?

Albuterol first, wait five minutes and then follow with flunisolide

Which of the following would a nurse identify as a surfactant?

Beractant

A client is experiencing an acute asthmatic attack. Which agent would be most effective?

Beta-2 selective adrenergic agonist

A client is given theophylline to treat acute asthma symptoms. Which food should the client avoid?

Chocolate

A nurse would expect to increase the dosage of theophylline if the client has a current history of which of the following?

Cigarette smoking

A patient tells you that a friend of theirs has recommended the use of caffeine to treat the patient's asthma. What would be the most important reason a nurse should counsel this patient not to delay prescribed treatment for the use of natural health products?

Delays in appropriate treatment can have serious, even fatal, consequences

When describing the action of xanthines, which would the nurse include? (Select all that apply.)

Direct effect on the mobilization of calcium within the cell Stimulation of 2 prostaglandins leading to smooth muscle relaxation Inhibition of release of slow-reacting substance of anaphylaxis

An adult client with newly diagnosed asthma presents for client education regarding situations that could precipitate an asthma attack. In this teaching, which precipitants would the nurse state may trigger an attack? Select all that apply.

Exercise Allergens Mold Cigarette smoke

After teaching a group of students about leukotriene receptor antagonists, the instructor determines a need for additional teaching when the students identify which agent as an example?

Fluticasone

A client with asthma is administered zileuton along with theophylline. The nurse should be especially alert for which of the following?

Increased serum theophylline

The triage nurse in the emergency department has a 42-year-old client with asthma present for treatment. The client's respiratory rate is 40 breaths per minute. Based on this objective data, what is the correct nursing diagnosis for this client?

Ineffective breathing pattern

A client is prescribed salmeterol. The nurse would expect this drug to be administered by which route?

Inhalation

The nurse is providing education to a client with asthma on the therapeutic action of inhaled corticosteroid agents. How will the nurse describe the action?

Inhaled corticosteroid agents reduce airway inflammation.

The client uses his sympathomimetic inhaler frequently. The nurse evaluates the client for which of the following symptoms related to frequent use of the sympathomimetic inhaler?

Nervousness

A client with a diagnosis of asthma has been prescribed ipratropium 2 puffs QID. What is the most likely goal of this treatment?

Promoting long-term management of asthma symptoms

A client, experiencing respiratory distress related bronchi constriction, will benefit from what therapeutic action provided by anticholinergic medication therapy?

Relaxation of smooth muscle

The nurse is providing education to a client who has been prescribed albuterol. What adverse reaction should the nurse discuss during teaching?

Tachycardia

Why are inhaled steroids used to treat asthma and COPD?

They act locally to decrease release of inflammatory mediators

A client is being assessed by the home care nurse for the appropriate use of a metered-dose inhaler. Instructions concerning which intervention will assist a client in the proper use of the device?

Using a spacer

A client has been admitted to the emergency department (ED) in status asthmaticus. The ED nurse should anticipate administering which medication?

beta2 agonists in high doses

What is the most common first-line therapy for relief of an acute asthma attack?

beta2-adrenergic agonist

A client is admitted to the emergency department with inspiratory stridor and air hunger. When anticipating treatment, the nurse will prepare which medication for administration?

epinephrine

What is considered a possible trigger for an asthma attack? Select all that apply.

exercise, allergens, pollutants, cigarette smoke

A client has been prescribed medication therapy for the treatment of newly diagnosed asthma. During teaching, the nurse should alert the client to potential exacerbation of what concurrent medical condition?

gastroesophageal reflux disease

A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his "puffers". In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to...

rebound bronchoconstriction

A nurse is providing health education to a client recently diagnosed with asthma and prescribed albuterol and ipratropium. Which of the client's statements suggests a need for clarification by the nurse?

"I'll keep taking my medications until I'm not experiencing any more symptoms."

A female client is prescribed systemic corticosteroids for her asthma. The nurse knows that the client is at risk for what problem?

Adrenal insufficiency

The nurse is caring for a client who is receiving IV theophylline for treatment of severe bronchospasm. The nurse will ensure that which item on the client's food tray will be held while the client is receiving theophylline?

Coffee

The nurse is reviewing a client's morning blood work and notes a theophylline level of 22.2 mcg/mL (123.21 µmol/L). What action should the nurse take?

Contact the care provider and inform him or her that the client has toxic theophylline levels.

A neonate is receiving beractant. The nurse understands that this agent is administered by which route?

Intratracheal

A newborn, experiencing ineffective alveolar expansion, is receiving treatment. What intervention should the nurse implement to assure the administration of the prescribed medication has been effective?

Monitoring respirations for bilateral chest movement

A nurse is providing education to a 56-year-old man who is admitted to the emergency department with an acute asthma attack. The nurse's initial assessment reveals that the patient has a history of pneumonia, drinks large quantities of coffee, and eats a high-calorie diet. Albuterol is prescribed for him. The important consideration when the nurse is preparing a teaching plan will be that the patient...

has a high coffee intake.