RESPIRATORY DRUGS
bronchodilators anticholinergics
TROPIUMs
Legal restrictions apply to the purchase of pseudoephedrine because of which of the following risks? a. respiratory depression b. drug abuse c. drug tolerance d. rebound congestion
b. drug abuse Rational: because it is possible to alter pseudoephedrine and epinephrine, the law restricts the drug's purchase
Which statement by a client best indicates an understanding of the teaching on flunisolide (AeroBid)? "I will rinse my mouth with water after each use." "I will wash the plastic inhaler casing once a month." "I will take two puffs to treat an acute asthma attack." "I will not use my albuterol inhaler while I am taking AeroBid."
"I will rinse my mouth with water after each use."
The nurse performs discharge teaching with a client who is prescribed the anticholinergic inhaler ipratropium bromide (Atrovent). Which statement by the client indicates to the nurse that teaching has been successful? "I will not drink grapefruit juice while taking this drug." "I may gain weight as a result of taking this medication." "This inhaler is not to be used alone to treat an acute asthma attack." "Nausea and vomiting are common adverse effects of this medication."
"This inhaler is not to be used alone to treat an acute asthma attack."
Client teaching regarding the use of leukotriene receptor antagonists (LTRAs) drugs such as zafirlukast (Accolate) would include which statement by the nurse? "It will take about 3 or 4 weeks before you notice a therapeutic effect." "Take the medication when you are short of breath and begin wheezing." "This medication works by preventing the inflammation that causes your asthma attack." "Increase fiber and fluid in your diet to prevent the common adverse effect of constipation."
"This medication works by preventing the inflammation that causes your asthma attack."
Which statement by the nurse should be included when teaching a client about the proper use of metered-dose inhalers? "After you inhale the medication once, repeat until you obtain relief." "Wait 1 to 2 minutes before you take a second puff of the same drug." "Make sure that you puff out air several times after you inhale the medication." "Hold the inhaler in your mouth, take a deep breath, and then compress the inhaler."
"Wait 1 to 2 minutes before you take a second puff of the same drug."
the nurse is teaching a patient about the inhaler Advair (salmeterol/fluticasone). which statements by the patient indicate a correct understanding of this medication?
"i will rinse my mouth with water after each dose" "this medication is taken twice a day, every 12 hours" "i will call my doctor if i notice white patches inside my mouth"
a patient who is taking a xanthine derivative for chronic bronchitis asks the nurse, "I miss my morning coffee. I cant wait to go home and have some." what is the nurse's best response
"it's important not to take coffee or other caffeinated products with this medicine as it may cause an increased heart rte as well as other problems"
You are instructing a patient about using cromolyn via inhalation to treat exercise-induced asthma. You should should advise the patient to take the drug
15 min before exercising
Nasal steroids
SONEs SONIDEs
the nurse is providing care to a client prescribed a nonselective adrenergic agonist bronchodilator. Which condition documented in the client's medical history would alert the nurse to question this prescription? Thrombocytopenia Coronary artery disease Mycobacterium tuberculosis Chronic obstructive pulmonary disease
Coronary artery disease
anti - histamines 2nd gen. h1 agonists
INEs
leukotriene agonists
KASTs TON
Which laboratory value would the nurse assess before administering zafirlukast (Accolate) to a client? Liver enzymes Cardiac enzymes Renal function tests Complete blood count
Liver enzymes
A nurse is providing education to a client taking two different bronchodilator medications. The nurse identifies which characteristic as the advantage of salmeterol (Serevent) over other beta2 agonists such as albuterol (Proventil)? Quicker peak action Shorter onset of action Extended time of action Longer duration of action
Longer duration of action
anti - inflammatories corticosteroids
ONEs CUS IDE
bronchodilators methlyxanthines
OPHYLLINEs
Decongestants
RINEs ZOLINEs
bronchodilators beta adrenergic agonists
ROLs
What is the role of corticosteroids in the treatment of acute respiratory disorders? They decrease inflammation. They directly dilate the bronchi. They stimulate the immune system. They increase gas exchange in the alveoli.
They decrease inflammation.
anti - histamines 1st gen. h1 antagonists
ZINEs NATE
a patient who has a history of asthma is experiencing an acute episode of SOB and needs to take a medication for immediate relief. the nurse will choose which med that is appropriate for this situation?
a beta agonist, such as albuterol
A health care professional is talking to a patient who is prescribed albuterol via inhaler and fluticasone (Advair) via inhaler for asthma management. The health care professional should tell the patient to use the albuterol inhaler before using the fluticasone inhaler for which of the following reasons? a. albuterol will increase the absorption of fluticasone b. albuterol will decrease inflammation c. albuterol will reduce nasal secretions d. fluticasone will reduce the adverse effects of albuterol
a. albuterol will increase the absorption of fluticasone Rational: Albuterol, an inhaled, short-acting beta2-agonist, causes broncholdilation, which will increase the absorption of fluticasone, an inhaled glucocorticoid, when the patient uses it before the glucocorticoid
When advising a patient about taking prednisone for chronic asthma, a health care professional should include which of the following information? a. avoid taking NSAIDs b. rinse your mouth after taking the drug to prevent a yeast infection c. stop taking the drug if you become nauseated d. change position slowly when standing up
a. avoid taking NSAIDs Rational: gastric protective measures are essential for patients who are taking oral glucocorticoids. Anti-inflammatory drugs can cause GI bleeding, so patients should not take them concurrently with prednisone.
A health care professional is advising a patient about the adverse effects of pseudoephedrine. Which of the following should the health care professional include? (select all that apply) a. restlessness b. bradycardia c. insomnia d. muscle pain e. anxiety
a. restlessness c. insomnia e. anxiety
A health care professional is monitoring plasma drug levels in a patient who is taking the theophylline. Which of the following adverse effects should the health care professional expect to see if the patient's level indicates toxicity? a. seizures b. constipation c. vomiting d. restlessness
a. seizures Rational: seizures are likely when plasma drug levels of theophylline, a methylxanthine, a higher than 30 mcg/mL, which indicates toxicity
A health care professional cautions a patient who is taking guaifenesin about using combination OTC cold products because: a. they can also contain guaifenesin b. serious interactions are possible c. rebound congestion is likely d. drug tolerance is likely
a. they can also contain guaifenesin Rational: many combination OTC cold products contain guaifenesin; a patient taking both might be taking excessive amounts of the drug.
For which of the following reasons should a patient attach a spacer to a metered-dose inhaler? a. to increase the amount of drug delivered to the lungs b. to increased the amount of drug delivered to the oropharynx c. to increase the amount of drug delivered on exhalation d. to increase the speed of drug delivery
a. to increase the amount of drug delivered to the lungs Rational: a spacer increases the amount of drug that reaches the lungs
You should instruct a patient who is taking zileuton (Zyflo) to report which of the following possible indications of a serious adverse effect of the drug?
abdominal pain
You are instructing a patient who is taking cetirizine (Zyrtec) how to treat allergic rhinitis. Which of the following information should the provider include?
administer the drug prophylactically during allergy seasons
Before prescribing dextromethorphan to a patient, the primary care provider should know that, when given with an opioid, the drug can result in which of the following? a. reduced antitussive effect of dextromethorphan b. potentiation of the analgesic effect of the opioid c. increased renal reabsorption of the dextromethorphan d. delayed analgesic effect of the opioid
b. potentiation of the analgesic effect of the opioid Rational: combining dextromethorphan with an opioid, such as morphine, increases the analgesic effect of the opioid
A health care professional who is advising a patient about the use of an expectorant to treat a cough should explain that this type of drug is effective because it performs which of the following actions? a. suppresses the cough stimulus b. reduces surface tension c. reduces inflammation d. dries mucous membranes
b. reduces surface tension Rational: Expectorants act by reducing the surface tension of respiratory secretions. This results in thinning thick mucus, making it easier to cough out of the lungs and drain out of the nose and sinuses
A health care professional should explain to a patient who is prescribed diphenydramine that the most common side effect associated with the drug is: a. muscle tremors b. sedation c. anxiety d. insomnia
b. sedation Rational: the most common adverse effect of diphendydramine, a first-generation antihistamine, is sedation
A health care professional is caring for a patient who is taking ipratropium (Atrovent). The health care professional should explain which of the following adverse effects to the patient? (Select all that apply.) a. muscle tremors b. urinary retention c. dry mouth d. insomnia e. tachycardia
b. urinary retention c. dry mouth
When explaining how a patient should use ipratropium (Atrovent), a health care professional should include which of the following instructions? a. do not drink anything for 30 min after using the drug b. wait 5 min between using the drug and another inhaled drug c. use the drug to abort acute bronchoconstriction d. check pulse rate after inhaling the drug
b. wait 5 min between using the drug and another inhaled drug Rational: Ipratropium, an inhaled anticholinergic, requires a 5-min wait between its administration and that of another inhaled drug to allow for its bronchodilating effects
A health care professional is caring for a patient who is having difficulty mobilizing thick respiratory secretions. Which of the following drugs should the health professional expect to administer? a. Ipratropium b. beclomethasone c. acetylcysteine d. azelastine
c. acetylcysteine Rational: Acetylcysteine is a mucolytic that loosens thick respiratory secretions
A health care professional who is advising a patient about using intranasal glucocorticoids should include which of the following instructions? a. starts at a low dose and gradually increase it b. take the drug as needed for nasal congestion c. allow at least 2 weeks for the full therapeutic effect d. use the drug prior to exercise
c. allow at least 2 weeks for the full therapeutic effect Rational: it can take 2 or 3 weeks to see the full effect from intranasal glucocorticoids
A health care professional is advising a patient about the use of beclomethasone to treat asthma. The health care professional should explain that the drug treats asthma because it performs which of the following actions? a. thins mucus b. relaxes bronchial smooth muscle c. decreases inflammation d. increases the cough threshold
c. decreases inflammation Rational: Beclomethasone, an intranasal glucocorticoid, treats asthma by reducing inflammation
A health care professional is advising a patient about the use of cromolyn sodium. Which of the following instructions should the health care professional instruction should the health care professional include? a. report signs of jaundice b. anticipate difficulty sleeping c. expect a bitter aftertaste d. increase calcium and vitamin D intake
c. expect a bitter aftertaste Rational: Cromolyn sodium, a mast cell stabilizer, leaves a bitter aftertaste. Taking sips of water or sucking on hard candy after use of the drug can minimize this effect
A health care professional who is advising a patient about the use of antihistamines to treat allergic rhinitis should explain that these drugs are effective because they perform which of the following actions? a. decreases viscosity of nasal secretions b. Blocks H2 receptors c. prevents histamine from binding to receptors d. reduces nasal congestion
c. prevents histamine from binding to receptors Rational: antihistamines treat allergic rhinitis and reduce swelling by blocking histamine from binding to the receptor sites
A health care professional is caring for a patient who is taking codeine. Which of the following is the most important assessment following administration of the drug? a. blood pressure b. apical heart rate c. respirations d. level of consciousness
c. respirations Rational: Codeine, an opioid agonist, is a severe respiratory depression.
A health care professional who is advising a patient about the use of a mucolytic to treat a cough should explain that this type of drug is effective because it performs which of the following actions? a. suppresses the cough stimulus b. reduces inflammation c. thins and loosen mucus d. dries secretions
c. thins and loosen mucous Rational: Mycolytics make mucus less viscous to increase a cough's productivity
anti - inflammatories monoclonial antibody mechanism of action
calms immune system down indication: severe persistent asthma
bronchodilators methlyxanthines mechanism of action
cause bronchodilation indication: COPD, asthma
A health care professional should recognize that using pseudoephedrine to treat allergic rhinitis requires cautious use with patients who have which of the following? a. peptic ulcer disease b. a seizure disorder c. anemia d. coronary artery disease
d. coronary artery disease Rational: because pseudoephedrine, an oral sympathomimetic, can cause systemic vasoconstriction, it requires cautions use with patients who have severe hypertension or CAD
When advising a patient about using zileuton, a health care professional should include which of the following instructions? a. check the apical pulse before taking the drug b. take the drug prior to exercising c. rinse the mouth after using the drug d. have laboratory tests performed at regular intervals
d. have laboratory tests performed at regular intervals Rational: Zileuton, a leukotriene modifier, can cause liver injury. The health care professional should monitor liver function once a month for 3 months, then every 2 to 3 months during the first year of treatment
When advising a patient who is beginning fluticasone propionate/salmeterol (Advair) therapy, which of the following instructions should a health care professional include? a. take the drug as needed for acute asthma b. follow a low-sodium diet c. use an alternate-day dosing schedule d. increase weight-bearing activity
d. increase weight-bearing activity Rational: weight-bearing activity can help minimize bone loss, which is a side effect of fluticasone propionate/salmeterol, an inhaled glucocorticoid
A health care professional should tell a patient who is taking albuterol to report which of the following possible indications of a serious adverse effects? a. fever b. bruising c. polyuria d. palpitations
d. palpitations Rational: Beta2 agonists can cause cardiac stimulation, resulting in chest pain, tachycardia, and hypertension.
A health care professional is advising a patient about the use of cromolyn sodium to prevent bronchospasm. The health care professional should explain that the drug prevents bronchospasm because it performs which of the following actions? a. increases leukocyte activity b. blocks muscarinic receptors c. causes bronchodilation d. reduces inflammation
d. reduces inflammation Rational: cromolyn sodium, a mast cell stabilizer, reduces inflammation by inhibiting the inflammatory response
Which of the following should a health care professional include when advising a patient about the use of montelukast? a. use a spacer to improve inhalation b. take the drug at the onset of bronchospasm c. rinse the mouth to prevent an oral fungal infection d. take the drug once a day in the evening
d. take the drug once a day in the evening Rational: Montelukast, a leukotriene modifier, is most effective when taken once per day in the evening
levalbuterol
dec. stimulation of the heart
leukotriene agonists mechanism of action
decrease inflammation indication: prevention, seasonal allergies
anti - inflammatories corticosteroids mechanism of action
decrease inflammation and enhance activity of beta agonists indication: prevention
You should monitor a patient taking dextromethorphan (Robitussin DM and others) due to the potential for which of the following?
drug abuse
You should recognize that codeine is contraindicated for patients who have which of the following?
emphysema
after a neb tx with the beta agonist albuterol, the patient complains of feeling a little shaky, with slight tremors of the hands. the patients HR is 98 bpm, increased from the pretreatment rate of 88 bpm. the nurse knows that this reaction is an
expected adverse effect of the med
Before administering an LTRA medication, the nurse would assess the client for allergies to which substance? (Select all that apply.) Latex Lactose Cellulose Povidone Chlorhexidine
lactose cellulose providone
You should instruct a patient using phenylephrine (Neo-Synephrine) spray for nasal congestion to do which of the following to avoid rebound congestion? (Select all that apply.)
limit the drug's use to 3-5 days add an intranasal glucocorticoid taper the dose prior to discontinuation restrict the drug's use to one nostril at a time
anti - inflammatories monoclonial antibody
omalizumab
You are obtaining a health history from a patient who is to start using a new ipratropium (Atrovent) inhaler. Which of the following information from the patient's history should alert you to take further action? (Select all that apply.)
peanut allergy glaucoma
during a teaching session for a patient who will be receiving a new prescription for the LTRA montelukast (singulair), the nurse will tell the patient that the drug has which therapeutic effect?
reduces inflammation in the airway
bronchodilators beta adrenergic agonists mechanism of action
relax and dilate airways indication: prevention, relief of asthma/bronchitis
bronchodilators anticholinergics mechanism of action
relax and dilate of bronchiole decrease secretions in COPD indication: prevention ass. with bronchitis/emphysema
after the patient takes a dose of an inhaled corticosteroid, such as flucticasone (flovent), what is the most important action the patient needs to do next?
rinse the mouth out with water
phosphodiesterase 4 inhibitor
roflumast indication: COPD management
a patient has been receiving an aminophylline (xanthinederivative) infusion for 24 hrs. the nurse will assess for which AE when assessing the patient during the infusion
sinus tachycardia
Which herbal product, when taken with theophylline, can decrease theophylline's serum drug levels? Garlic Echinacea Peppermint oil St. John's wort
st. john's wort
Discharge teaching to a patient receiving a beta-agonist bronchodilator should emphasize reporting which side effect? Tachycardia Nonproductive cough Hypoglycemia Sedation
tachycardia
Which of the following information indicates to you that a patient who is taking theophylline (Theo-24) needs further instruction?
the patient drinks two cups of coffee each morning
The nurse receives laboratory values for a client with a theophylline level of 14 mcg/mL. How does the nurse interpret this theophylline level? Toxic Therapeutic Subtherapeutic Life threatening
therapeutic
mucolytics acetylcysteine mechanism of action
thins out mucus
Which of the following information should you include when teaching a patient about using an albuterol (Proventil) inhaler for asthma?
use it periodically to prevent exercise-induced asthma
You should advise a patient who is taking beclomethasone (QVAR) to monitor for which of the following possible indications of an adverse effect of the drug?
white coating in the mouth
