PrepU Chapter 55: Drugs Acting on the Lower Respiratory Tract
The parents of a 7-year-old client who has been diagnosed with allergic asthma are being taught about their son's medication regimen. The nurse is teaching about the appropriate use of a "rescue drug" for acute exacerbations. What drug should the nurse suggests the parents to use in these situations?
Albuterol
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
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."
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 client has mild, persistent asthma. The nurse anticipates the healthcare provider prescribing which daily medications?
Fluticasone
A client is given theophylline to treat acute asthma symptoms. Which food should the client avoid?
Chocolate
Which medication is contraindicated for the treatment of acute bronchospasm?
Cromolyn
While reviewing a client's history, an allergy to which of the following would alert the nurse to a possible problem with the use of ipratropium?
Peanuts
A 27-year-old athlete with newly diagnosed asthma presents for patient education regarding situations that could precipitate an asthma attack. The nurse teaches that acute episodes of asthma may last minutes to hours. In this teaching, which precipitants would the nurse state may cause the asthma? (Select all that apply.)
Pollutants Exercise Allergens
A client, experiencing respiratory distress related bronchi constriction, will benefit from what therapeutic action provided by anticholinergic medication therapy?
Relaxation of smooth muscle
After teaching a group of students about inhaled steroids, the instructor determines that the teaching was successful when the students state:
The drugs are not for use during an acute attack
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 on the appropriate use of her metered-dose inhalers. Instructions concerning which intervention will assist a client in the proper administration of the metered-dose inhaler?
Using a spacer
What is the most common first-line therapy for relief of an acute asthma attack?
beta2-adrenergic agonist
A client has been prescribed theophylline intravenously and began the therapy three days ago. The nurse suspects that the serum drug level is above therapeutic levels when the client makes what statement(s)? Select all that apply.
"I don't want lunch; I'm feeling nauseated." "It feels like my heart is beating faster than usual." "The headache I mentioned yesterday still hasn't gone away." "I need to tell you that I vomited a few minutes ago."
An adolescent client is prescribed a leukotriene receptor antagonist as a part of a medication regime to manage his/her asthma. Which statement made by the client requires additional education on this classification of medications?
"I need to take the medication when I start to have problems breathing."
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."
The nurse assesses the serum theophylline of a client. Which finding would the nurse identify as being therapeutic?
15 mcg/mL
A client is using an inhaled bronchodilator as treatment for exercise-induced asthma. The nurse would instruct the client to use the inhaler at which time?
15 minutes before engaging in exercise
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 has been admitted to a health care facility with asthma. The nurse is to administer theophylline to the client. To which clients can the nurse safely administer theophylline?
A 65-year-old male with asthma
A male client presents to the emergency department in bronchospasm. He has a history of smoking two packs per day for 20 years and is prescribed phenytoin to control a seizure disorder that developed after a head injury 3 years ago. Based on the client's history, what would the nurse expect the health care provider to order?
A modified dose of aminophylline
A female client is prescribed systemic corticosteroids for her asthma. The nurse knows that the client is at risk for what problem?
Adrenal insufficiency
A male client presents with symptoms of bronchospasm that occurred during a birthday party for his grandson. What medication would the nurse expect the health care provider to give the client?
Albuterol
After reviewing information about drugs used to treat lower respiratory system conditions, a group of nursing students demonstrate understanding of the information when they identify which as an example of a short-acting beta-2 agonist (SABA)?
Albuterol
During the summer, a female client experiences increased periods of acute symptoms of her asthma. The health care provider increases the dose frequency of which of her medications?
Albuterol
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
A patient with COPD presents at the Emergency Department (ED) in acute respiratory distress. The patient's family tells the nurse that the patient takes Atrovent and started having problems right after tasting soy milk. What would the nurse suspect is the problem?
An allergy to soy products
Which of the following would a nurse identify as a surfactant?
Beractant
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 client prescribed antiasthmatic drugs should be encouraged to avoid excessive intake of what beverage?
Coffee
A nurse is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The nurse will question the patient about her intake of which of the following?
Coffee
The client's theophylline levels are increased when the lab results are added to the electronic health record. The nurse questions the client about his intake of which?
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 group of students are reviewing the various drugs that affect inflammation. The students demonstrate understanding when they identify which agent as a mast cell stabilizer?
Cromolyn
A 5-year-old boy is brought to the ED with an asthma exacerbation, including wheezing (a high-pitched, whistling sound caused by turbulent airflow through an obstructed airway). Those who have asthma chronically present with what signs, even when they may appear symptom free? (Select all that apply.)
Damaged airway mucosa Airway inflammation
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 medical condition is likely to be exacerbated by the medication therapy associated with asthma?
Gastroesophageal reflux disease (GERD)
Where should the nurse initially direct a client who is interested in learning more about the management of asthma?
Global Initiative for Asthma (GINA)
An older adult client has been prescribed an inhaled corticosteroid for the treatment of chronic obstructive pulmonary disease (COPD). Which action should the nurse perform to reduce the client's risk for developing oral candidiasis?
Have the resident rinse his or her mouth after each dose of the drug
A client with asthma is administered zileuton along with theophylline. The nurse should be especially alert for which of the following?
Increased serum theophylline
A client is prescribed salmeterol. The nurse would expect this drug to be administered by which route?
Inhalation
How do inhaled corticosteroid agents assist in the treatment of asthma?
Inhaled corticosteroid agents will reduce airway inflammation
A neonate is receiving a beractant. The nurse understands that this agent is administered by which route?
Intratracheal
A male client is prescribed montelukast and uses it successfully to manage his asthma. He develops hepatitis C. What would the nurse expect the health care provider to do?
Maintain the same dose of the montelukast
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
Which of the following would be most important to assess before administering calfactant? (Select all that apply.)
Oxygen saturation levels Lung sounds Endotracheal tube replacement
A patient presents at the Emergency Department (ED) in acute respiratory distress. A quick assessment by the triage nurse indicates that the patient experienced difficulty breathing immediately after taking Combivent for the first time. The nurse suspects that the patient may be allergic to what?
Peanuts
A female client presents to the emergency department with acutely deteriorating asthma. Her husband tells the nurse that his wife takes salmeterol. He then tells the nurse that he gave her three extra puffs when she became ill. What statement is correct in this situation?
Salmeterol is contraindicated based on his wife's condition
What is considered a possible trigger for an asthma attack? Select all that apply.
Exercise Allergens Pollutants 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 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
A nurse is administering levalbuterol to a client. The nurse would administer this drug by which route?
Inhalation
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