Ch 55: Drugs Acting on the Lower Respiratory Tract

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."

Which statement by a client who is prescribed triamcinolone indicates the need for additional teaching?

"I should see some results in about 3 to 4 days."

The client has been prescribed cromolyn (Intal) for the treatment of asthma, and the nurse is evaluating the client's understanding of the medication. Which statement by the client indicates the need for further education?

"I will use this medication when I am having an asthma attack."

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."

Which of the following would be most important to assess before administering calfactant? (Select all that apply.)

- Endotracheal tube placement - Lung sounds - Oxygen saturation levels

What pathology is present in a client diagnosed with chronic asthma even when they may appear symptom free? Select all that apply.

- airway inflammation - damaged airway mucosa

Adrenergics are a category of bronchodilators used in the treatment of asthma and chronic obstructive pulmonary disease. In what conditions is cautious use of these drugs recommended? Select all that apply.

- diabetes mellitus - hypertension - seizure disorders

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

15 mcg/mL

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

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

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

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

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.

A client is prescribed a leukotriene receptor antagonist. The nurse should evaluate the effectiveness of the medication therapy based on the long term management of symptoms associated with which respiratory condition?

Asthma

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

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

Beta2-adrenergic agonist

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

Chocolate

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 nurse is providing education to a client who has been prescribed an antiasthmatic drug. The nurse should instruct the client to avoid excessive intake of what beverage?

Coffee

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

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

Where should the nurse initially direct a client who is interested in learning more about the management of asthma?

Global Initiative for Asthma (GINA)

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

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?

Inform the health care provider that the client has toxic theophylline levels.

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

Inhalation

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

Intratracheal

Mark, 8 years old, is prescribed flunisolide. The physician advises Mark and his parents to use a spacer when administering this medication. What is the benefit of such use?

It helps decrease systemic absorption.

Which agents would the nurse identify as selectively and competitively blocking the receptors for the production of two substances that are components of SRSA?

Leukotriene receptor antagonists

Which medication is used to treat acute airflow obstruction?

Metaproterenol

An 8-year-old child with an acute asthmatic attack is receiving metaproterenol via nebulizer. Which of the following would be most appropriate?

Mix the drug with saline.

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

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

The nurse is writing a plan of care for a patient newly admitted to the floor with asthma. What would be an appropriate intervention for this patient?

Prophylaxis by prior inhalation of bronchodilating agents is better than avoiding exercise.

The client with asthma has been ordered an inhaler and the nurse is teaching how to prevent Candida infections. Which would the nurse include in the instructions?

Rinse mouth with water after each use.

The nurse is evaluating the education of a client that uses albuterol for an acute asthma attack. The nurse knows that the lesson has been effective when the client states that albuterol is which of the following types of medication?

SABA

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

Tachycardia

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 male patient is to begin treatment for pneumonia with an albuterol (Ventolin) inhaler. The nurse will advise the patient that he will most likely experience which common adverse effects of the drug?

Throat irritation

Which medication is contraindicated for the treatment of acute bronchospasm?

cromolyn

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 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.

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

The nurse should complete which of the following during acute breathing distress before initiation of a bronchodilator? Select all that apply:

- Check respiratory rate - Check blood pressure. - Check pulse.

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

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 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 drugs as bronchodilators, the instructor determines that the teaching has been successful when the students identify which group of drugs as once being first-line agents?

Xanthines

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

A nurse is teaching a newly diagnosed client with asthma how to manage the disease. What should the nurse encourage this client to do?

stop smoking cigarettes

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 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

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

An older adult client has been prescribed an inhaled corticosteroid for the treatment of chronic obstructive pulmonary disease. When administering the drug, what 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 who smokes is receiving theophylline orally. Because of his history of smoking, the nurse expects the health care provider to do what with the theophylline dosing?

Increase

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

Increased serum theophylline