respiratory medications
When evaluating an asthmatic client's knowledge of self-care, the nurse recognizes that additional instruction is needed when the client makes which statement?
"I use my corticosteroid inhaler each time I feel short of breath."
A client with a prescription to take theophylline daily has been given medication instructions by the nurse. What statement by the client indicates the need for further educationregarding the prescription?
"I will take the daily dose at bedtime."
A client with chronic obstructive pulmonary disease (COPD) is being changed from an oral glucocorticoid to triamcinolone by inhalation. The client asks why this change is necessary. Which statement by the nurse to the client is accurate?
"Inhaled glucocorticoids are preferred because of decreased adverse effects."
A client has begun therapy with a xanthine bronchodilator. The nurse determines that the client understands dietary alterations if the client states to limit which items while taking this medication? Select all that apply.
- Coffee - Chocolate
The client questions the nurse as to why the health care provider switched the usual prescription from a metered-dose inhaler (MDI) to a dry powder inhaler (DPI). The nurse should respond correctly by providing which facts? Select all that apply.
- Dry powder inhalers pose no environmental risks. - Dry powder inhalers deliver more medication to the lungs. - Dry powder inhalers require less hand-to-lung coordination.
Rifabutin side effects and adverse effects
- Signs of hepatitis - Flulike syndrome - Low neutrophil count - Ocular pain or blurred vision
A client who has been receiving theophylline by the intravenous (IV) route has the medication prescription changed to an immediate-release oral form of the medication. After discontinuing the IV medication, when should the nurse schedule the first dose of the oral medication?
4 hours after discontinuing the IV form
isoniazid
A common side effect of isoniazid is peripheral neuritis(peripheral neuropathy), manifested by numbness, tingling, and paresthesias in the extremities. This can be minimized with pyridoxine (vitamin B6) intake.
Which supplies should the nurse obtain for the administration of ribavirin to a hospitalized child with respiratory syncytial virus (RSV)?
A mask and pair of goggles
expectorant
A medication that helps bring up mucus and other material from the lungs, bronchi, and trachea
The client has a prescription to receive pirbuterol 2 puffs and beclomethasone dipropionate 2 puffs by metered-dose inhaler. The nurse plans to give these medications in which way to ensure effectiveness?
Administering the pirbuterol before the beclomethasone Bronchodilators are administered before glucocorticoids when both are to be given on the same time schedule
omalizumab
Anaphylactic reactions can occur with the administration of omalizumab. The nurse administering the medication should monitor for adverse reactions of the medication. Swelling of the lips and tongue are an indication of an anaphylaxis
A client with an exacerbation of chronic obstructive pulmonary disease (COPD) has been on oral glucocorticoids and is currently being weaned to triamcinolone by inhalation. The nurse determines that the client understands the potential adverse effects to watch for during this medication change when the client states the need to report which signs and symptoms?
Anorexia, nausea, weakness, and fatigue
The nurse is teaching a client about the effects of diphenhydramine, an ingredient in the cough suppressant prescribed for the client. The nurse should plan to tell the client to take which measure while taking this medication?
Avoid activities requiring mental alertness. the medication causes drowsiness, the client should avoid use of alcohol or central nervous system depressants, operating a car, or engaging in other activities that require mental acuity.
isoniazid
Because isoniazid therapy can cause elevated hepatic enzymes and hepatitis, liver enzymes (ALT, AST) are monitored when therapy is initiated and during the first 3 months of therapy. They may be monitored longer in the client who is older than 50 years of age or who abuses alcohol. The normal AST level is 0 to 35 U/L (0 to 30 U/L).
Benzonatate
Benzonatate is a locally acting antitussive that decreases the intensity and frequency of cough
which to administer first bronchodilator or steroid
Bronchodilators are always administered before glucocorticoids when both are to be given on the same time schedule. This allows for widening of the air passages by the bronchodilator, which then makes the glucocorticoid more effective.
The health care provider (HCP) has prescribed codeine sulfate for a client with a nonproductive cough to suppress the cough reflex. The nurse should teach the client to monitor for which side effect of the medication?
Constipation Codeine sulfate is an opioid analgesic, and a frequent side effect is constipation.
A clinic nurse is assessing a client who has been on isoniazid for 6 months. Which client complaint should most concern the nurse?
Difficulty tying shoes The client complaint that should most concern the nurse is difficulty tying shoes because this may indicate neuropathy. Dose-related peripheral neuropathy is one of the more common adverse effects of isoniazid
A client is taking cetirizine. The nurse should inform the client of which side effect of this medication?
Drowsiness Cetirizine is an antihistamine; frequent side effects are drowsiness or sedation.
Isoniazid
For children with HIV infection who demonstrate a positive tuberculin skin test result, a minimum of 12 months of treatment with isoniazid is recommended.
function of steroid medication
Glucocorticoids are a type of corticosteroid hormone that is very effective at reducing inflammation and suppressing the immune system. Inflammation is the way our immune system responds to harmful substances and trauma and is part of our healing process. Continuous use of this medication lessens the immune response which will cause infection also this medication can cause hyperglycemia
Which statement made by a client taking montelukast indicates the need for further teaching?
I will take the medication when I first notice I am having trouble breathing." Montelukast cannot be used for quick relief of an asthma attack because effects of the medication develop too slowly.
A client taking theophylline has a serum theophylline level of 15 mcg/mL (60 mcmol/L). How does the nurse interpret this laboratory value?
In the middle of the therapeutic range The normal therapeutic range for the theophylline level is 10 to 20 mcg/mL (40 to 79 mcmol/L). A level above 20 mcg/mL (79 mcmol/L) is considered toxic.
Cromolyn sodium is prescribed for the client with allergic asthma. What goal does the nurse expect to achieve by administration of this medication?
Inhibition of the release of mediators from mast cells after exposure to an antigen is an antiasthmatic, antiallergic, and mast cell stabilizer that inhibits the release of mediators from mast cells after exposure to an antigen
diphenhydramine
Instructions for use include taking with food or milk to decrease gastrointestinal upset and using oral rinses, sugarless gum, or hard candy to minimize dry mouth.
isoniazid
Isoniazid is hepatotoxic, and therefore the client is taught to report signs and symptoms of hepatitis immediately, which include yellow skin and sclera. For the same reason, alcohol should be avoided during therapy. Vitamin B6 deficiency and numbness and tingling in the extremities
Terbutaline
It should be used with caution in clients with impaired cardiac function, diabetes mellitus, hypertension, hyperthyroidism, or a history of seizures. The medication may increase blood glucose levels.
The nurse is preparing to administer albuterol to a client. Which parameters should the nurse assess before and during therapy?
Lung sounds and presence of dyspnea
morphine
Opioid Analgesic Naloxone should be readily available for use if respiratory depression should occur.
Ethambutol
Optic neuritis is an inflammation of the eye's optic nerve. causes optic neuritis, which decreases visual acuity and the ability to discriminate between the colors red and green. This form of color blindness poses a potential safety hazard in driving a motor vehicle. The client is taught to report this symptom immediately.
A home care nurse has observed a client self-administer a dose of an adrenergic bronchodilator via metered-dose inhaler. Within a short time, the client begins to wheeze loudly. The nurse understands that this is the result of which occurrence?
Paradoxical bronchospasm, which must be reported to the health care provider (HCP) The client taking adrenergic bronchodilators may experience paradoxical bronchospasm, which is evidenced by the client's wheezing
The nurse would anticipate that the health care provider (HCP) would add which medication to the regimen of the client receiving isoniazid?
Pyridoxine Clients receiving isoniazid can develop neuropathy, and the agent of choice to help prevent this adverse effect is pyridoxine, vitamin B6
albuterol
Side and adverse effects include tachycardia, hypertension, chest pain, dysrhythmias, nervousness, restlessness, and headache
The health care provider prescribes cromolyn for the client with asthma. The nurse identifies that the client correctly understands the purpose of this medication when the client states that the medication will produce which effect?
Suppress an allergic response
Intranasal corticosteroids
The medication works locally and decreases inflammation.
Theophylline
The therapeutic serum level range is 10 to 20 mg/mL (40 to 79 mcmol/L).
A client is scheduled to receive acetylcysteine 20% solution diluted in 0.9% normal saline by nebulizer. Which outcome would the nurse expect as a result of the administration of this medication?
Thinning of respiratory secretions
Cromolyn sodium
Undesirable effects associated with inhalation therapy of cromolyn sodium are bronchospasm, cough, nasal congestion, throat irritation, and wheezing.
Which is the nurse's priority assessment for monitoring for adverse effects for the client taking isoniazid?
Urine color Dark urine is a sign of liver injury and the client should be taught to report this, and the nurse should assess for this
A client with tuberculosis (TB) has a prescription for rifampin. What instruction should the nurse include in the client's teaching plan?
Wearing glasses instead of soft contact lenses will be necessary. Soft contact lenses may be permanently damaged by the orange discoloration in body fluids caused by rifampin
Guaifenesin
an expectorant and should be taken with a full glass of water to decrease the viscosity of secretions.
Rifampin
causes orange-red discoloration of body secretions and will stain soft contact lenses permanently.
theophylline
is a methylxanthine bronchodilator. The nurse teaches the client to limit the intake of xanthine-containing foods while taking this medication. These foods include coffee, cola, and chocolate.
Theophylline
is a xanthine bronchodilator. Before a serum level of the medication is drawn, the client should avoid taking foods or beverages that contain xanthine, such as colas, coffee, or chocolate; therefore, the client is told to avoid coffee before the test
Acetylcysteine
is administered to thin bronchial secretions and is considered a mucolytic.
pirbuterol
is an adrenergic bronchodilator. Side and adverse effects include tachycardia, hypertension, chest pain, dysrhythmias, nervousness, restlessness, and headache
Pyrazinamide
is an antituberculosis medication that is given in conjunction with other antituberculosis medications. Its use may be discontinued by the prescriber if sputum cultures become negative
Cycloserine
is an antituberculosis medication that requires weekly serum medication level determinations to monitor for neurotoxicity and other adverse effects. Peak concentrations are measured 2 hours after dosing and should be between 25 and 35 mcg/mL.
Ribavirin
is an antiviral respiratory medication used mainly for hospitalized children with severe RSV. Administration is via hood, face mask, or oxygen tent.
theophylline
take the medication early in the morning. This enables the client to have maximal benefit from the medication during daytime activities.
Zafirlukast
used with caution in clients with impaired hepatic function. Liver function laboratory tests should be performed to obtain a baseline, and the levels should be monitored during administration of the medication