Chapter 55: Drugs Acting on the Lower Respiratory Tract

The nurse is teaching a client newly diagnosed with asthma about triggers. Which statement by the client indicates the client understands the teaching plan?

"I will use my air conditioner."

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

15 mcg/mL

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

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 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 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 nurse would expect to increase the dosage of theophylline if the client has a current history of which of the following?

Cigarette smoking

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

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

Intratracheal

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.

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.

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

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."

A client is receiving ipratropium as maintenance therapy for chronic obstructive pulmonary disease. The nurse would caution the client that up to how many inhalations may be used in 24 hours if needed?

12

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 premature newborn diagnosed with respiratory distress syndrome(RDS) has received surfactant therapy. The infant's nursing care plan should include which monitoring interventions to evaluate the effectiveness of the therapy? Select all that apply.

Adventitious breath sounds Endotracheal tube placement Respirations Chest movement

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

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 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.)

Allergens Pollutants Exercise

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 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

A client was using a nicotine patch to stop smoking when he was started on theophylline for emphysema. He has successfully stopped smoking and has stopped using his nicotine patch. Which of following would the nurse anticipate about the prescribed theophylline?

Dose should be decreased.

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 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

A client with COPD takes theophylline. The nurse identifies that the client is still experiencing severe dyspnea. Upon review of labs, the theophylline level remains nontherapeutic. The nurse evaluates the client for which of the following drugs that may cause decreased theophylline levels?

Nicotine

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

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 describing how aminophylline achieves its effect. Which would the nurse incorporate into the description?

Stimulation of the central nervous system

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

beta2-adrenergic agonist

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

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.