219 Respiratory Practice
A nurse is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuterol, both by nebulizer. Which of the following statements by the client indicates an understanding of the teaching?
"I will be sure to take the albuterol before taking the cromolyn"
A nurse is evaluating teaching on a client who has a new prescription for Montelukast to treat asthma. which of the following statements by the client indicates an understanding of the teaching?
"I'll take this medication once a day in the evening"
Decongestant - Sudafed adverse effects
Anticholinergic effects, nervousness, agitation, palpitations and rebound congestion. Risk for abuse, contraindicated with hypertension or cardiac disorders.
Duo-neb
Atrovent combined with albuterol
A nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide?
Rinse the mouth after administration
A nurse is assessing four clients on a medical unit. The nurse should identify which of the following clients as exhibiting positive manifestations of hypercortisolism?
Moon face
Albuterol are taken for
acute causes bronchodilation and smooth muscle relaxation (prevents bronchospasms). may cause jitters. check pulse
Codeine adverse effects
same as opioid. GI, GU, CNS depression, Respiratory depression
respiratory acidosis
pH < 7.35, PaCO2 > 45, HCO3 >26
Mucolytic: Acetylcysteine treats
pulmonary disorders with thick secretions (CF), antidote for Acetaminophen Overdose. Use cautiously in asthma patients. Risk for bronchospasm. Smells like rotten eggs, sulfur.
A nurse is teaching a client who has diabetes mellitus and a new prescription for prednisone for a rash. which of the following statements by the client indicates the need for further teaching>
"I will gradually stop the prednisone when my rash goes away"
A nurse is reviewing discharge instructions with a client who has rheumatoid arthritis and a new prescription for prednisone. which of the following statements by the client indicates an understanding of the teaching?
"I should eat more bananas while taking this medication"
A nurse is caring for a client who has poison ivy and is prescribed diphenhydramine. which of the following instructions should the nurse give regarding the adverse effects of dry mouth associated with diphenhydramine?
"Chew won sugarless gum or suck on hard, sour candies"
how long should you wait after taking albuterol before taking something else
5 minutes before taking an inhaled glucocorticoid (Beclomethasone)
salmeterol is
A long acting B-adrenergic
A nurse is providing discharge instructions to a client who has asthma and a new prescription for Montelukast. The nurse should instruct the client to report which of the following adverse effects to provider?
Depression
Expectorant- Guaifenesin (Mucinex) adverse effects
GI upset, drowsiness, rash
A nurse is assessing a client who has Cushing's syndrome. Which of the following findings should the nurse expect?
Hyperpigmentation
A nurse in an emergency department is preparing to administer theophylline by continuous intravenous (IV) infusion to a client who is experiencing an asthma attack. Which of the following actions should the nurse take?
Infuse the medication with an IV pump
A nurse is providing discharge instructions to a client who has asthma and is about to start theophylline (Theo-24). The nurse should tell the client that this medication might cause which of the following adverse effects?
Tachycardia
A nurse is caring for a client who is taking Montelukast. Which of the following outcomes indicates a therapeutic effect of the medication?
The client experiences an increased ease of breathing
A nurse is assessing a client who has chronic respiratory insufficiency. which of the following findings should the nurse expect as result of the long-term inadequate oxygenation?
clubbing of the fongers
Albuterol and Salmeterol adverse effects
tachycardia, angina, tremors
A nurse is caring for a client who has Cushing's syndrome. The nurse should recognize that which of the following are manifestations of Cushing's syndrome? (select all that apply)
Alopecia Moon face Purple striations Buffalo hump
Montelukast (Singular) treats
asthma or exercise-induced bronchoconstriction. Take this at night or 2 hours before exercise. Long-term chronic medication. Take this medication on a continuous schedule even if symptoms improve.
A nurse is providing teaching to a client who has emphysema and a new prescription for theophylline. Which of the following instructions should the nurse provide?
Avoid caffeine while taking this medication
A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. the nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects?
adrenocortical insufficiency
A nurse is caring for a child who is experiencing status asthmaticus. which of the following interventions is the priority for the nurse to take?
Administer a short-acting B2-agonist (SABA)
A nurse is caring for child who has asthma and a prescription for Montelukast granules. Which of the following instructions should the nurse provide the client's parent on administering the medication?
Administer the medication 2 hr before exercise
Prednisone adverse effects
Bone loss, fluid retention, moon face, hyperglycemia, hypernatremia, hypocalcemia, hypokalemia, immunosuppression, muscle weakness, peptic ulcer dz, adrenocortical insufficiency. Cushing's Syndrome.
A nurse is teaching a client who has a new diagnosis of asthma. which of the following medications should the nurse instruct the client to use to abort an acute asthma attack?
albuterol
Ipratropium (Atrovent) treats
asthma, COPD
Glucocorticoids are used for
decreasing inflammation
A nursing is providing dietary teaching for a client who has Cushing's disease. which of the following recommendations should nurse include in the teaching?
restrict sodium intake
Decongestant - Sudafed treats
rhinitis and can be used to make meth
Diphenhydramine (Benadryl)/Loratadine (Claritin) treats
rhinitis, allergic reaction and motion sickness. It decreases mucous histamine. Causes sedation and Anticholinergic effects
A nurse is teaching a client about taking diphenhydramine. the nurse should explain to the client that which of the following is an adverse effect of this medication?
sedation
A nurse is caring for a client who has Parkinson's disease and is taking diphenhydramine 25 mg PO TID. Which of the following therapeutic outcomes should the nurse expect to see?
decreased tremors
A nurse is teaching a client who has chronic obstructive pulmonary disease and is to stat using fluticasone by MDI twice daily. Which of the following instructions should the nurse include?
"Inspect your mouth for lesions daily"
Nystatin (Mycostatin) is taken for
candidiasis when using glucocorticoids; used by swish and swallow, no eating or drinking for 30 minutes. Last PO med to be given.
Ipratropium (Atrovent) adverse effects
causes dry mouth and hoarseness. Can't see, pee, spit, or poop. Educate patient to increase fluid, fiber, exercise, and suck on hard candy.
A nurse is teaching a client who has a new prescription for prednisone to treat rheumatoid arthritis. the nurse should inform the client that which of the following is a therapeutic effect of this medication>
decreases inflammation
Codeine treats
dry, non-productive cough that they can't get ride of. Also called lean. Educate fluid, fiber and exercise. No driving. Change positions slowly, Orthostatic hypotension.
Beclomethasone adverse effects
hoarseness, candidiasis (fungal infection) Consider rinsing mouth after administration. Use a spacer with all inhalers if patients have diffitculty.
Montelukast (Singular) adverse effects
increased liver enzymes, depression
Theophylline (Aminophylline) therapeutic response
is ease of breathing. Works on the CNS and may cause tachycardia, palpitations or dysrhythmias. Watch taking other stimulants.
Theophylline (Aminophylline) treats
long term care for COPD and asthma. Increases cAMP and bronchodilation
Cushing's syndrome
may be caused by hyperplasia of adrenal cortex or pituitary tumor
Expectorant- Guaifenesin (Mucinex) treats
non-productive cough with respiratory infection and the medication stimulates secretions. Patients should be educated on drinking plenty of water.
A nurse is caring for a client who has asthma has asthma and is taking fluticasone. the nurse should monitor the client for which of the following adverse effects?
oral candidiasis
Mometasone (Nasonex) Fluticasone (Flonase) adverse effects
pharyngitis, headache or nasal bleeding. Can cause rebound congestion
Theophylline (Aminophylline) adverse effects
seizures and dysrhythmias, GI upset, tachycardia (CNS stimulants).
A nurse is teaching a client about taking an expectorant to treat a cough. the nurse should explain that this type of medication has which of the following actions
stimulates secretions
Prednisone considering factors
stress may require additional doses. Do not stop suddenly (must taper slowly). Monitor for signs of infection. Avoid NSAIDS. Can decrease efficacy of other medication. Taper of doses to avoid adrenocortical insufficiency. IV solumedrol (methylprednisolone) may be given IV for acute attack.
A nurse is teaching a client who has asthma about how to use an albuterol inhaler. Which of the following actions by the client indicates an understanding of the teaching?
the client holds hos breath for 10 seconds after inhaling the medication
A nurse is caring for a client who asks how albuterol helps his breathing. Which of the following responses should the nurse make? (select all that apply)
the medication will prevent wheezing the medication will open the airways the medication will decrease coughing episodes
Mometasone (Nasonex) Fluticasone (Flonase) are used to
treat rhinitis and nasal congestion, its a nasal steroid
A nurse is preparing to transfuse one unit of packed RBC to a client who experienced a mild allergic reaction during a previous transfusion. The nurse should administer diphenhydramine prior to the transfusion for which of the following allergic responses?
urticaria
Glucocorticoids like Prednisone with chronic autoimmune disorders (RA, Lupus) take then
when they have flare ups
A nurse is providing discharge teaching to a client who has asthma and a new prescription for fluticasone/salmeterol. for which of the following adverse effects should the nurse instruct the client to report to the provider?
white coating in the mouth