Pharmacology Gas Exchange

A client calls the nurse advice line and states that her allergies have been extremely bad due to high pollen counts. She stated that she went off of her medications because she was pregnant and wanted to verify, now that she had her baby, if it was okay to begin her antihistamine again. Her chart indicates that she has no other conditions that contraindicate antihistamine use. How should the nurse respond? "You should not go back on this medication for one (1) year after birth." "There are no issues with you beginning this medication again." "What was your previous dosage?" "Are you breastfeeding your baby?"

"Are you breastfeeding your baby?"

A patient taking theophylline reports drinking 2-3 energy drinks everyday due to low energy. What is an appropriate response by the nurse of those listed below? "Drinking energy drinks is fine, but please do not increase the amount you currently consume." "Energy drinks contain a large amount of caffeine which is not good to mix with theophylline." "Energy drinks are bad for you. You should not drink them." "Energy drinks cause seizures and should be avoided."

"Energy drinks contain a large amount of caffeine which is not good to mix with theophylline."

A pediatric client with asthma has just received omalizumab. The client's guardian asks who prescribed the medication and why. Which response by the nurse best answers the guardian's question? ​ "It is for asthma that is not controlled by other meds and was ordered by the health care provider."​ "This medication is new and will relax the smooth muscles in the lungs to effectively cure asthma. I am not sure who prescribed this but am sure it is safe. Would you like me to print some information for you to read?"​ "The medication is omalizumab and it blocks an allergic reaction that is common in people with asthma. It was ordered this morning by your child's pediatrician and will be given along with their other asthma medications."​ "This is the first time I have given this, so I just read up on it. The pill is extended release, so it will work through the day. This means that an allergic reaction can occur anytime over the next day and we will me assessing for any adverse reactions."​

"The medication is omalizumab and it blocks an allergic reaction that is common in people with asthma. It was ordered this morning by your child's pediatrician and will be given along with their other asthma medications."​

Antihistamines have many names that use which suffix? -ine -lol -ergic -pril

-ine

What is the typical dosing range for ipratropium? 0.25- 0.5mg per 2.5mL 0.25- 0.5mg per 5mL 0.5 - 0.25mg per 5mL 0.5 - 0.25mg per 2.5 mL

0.25- 0.5mg per 2.5mL

At what age is it safe for montelukast to be taken? 1 year of age 2 years of age 3 years of age 4 years of age

1 year of age

What is the maximum dose of montelukast for a 24-hour period?​ 20mg ​5mg​ 15mg​ 10mg​

10 mg

What is the maximum number of sprays per nostril in adults in a day?​ 1 spray​ 3 sprays​ 4 sprays​ 2 sprays​

2 sprays

What is the minimum age that fluticasone can be given?​ 2 years old​ 13 years old​ 18 years old​ 6 months​

2 years old

One single, standard dose of theophylline is equivalent to how many cups of coffee? 3 2 5 4

3

When considering oral albuterol, there is a maximum dose. For adults, this is (23, 32) mg per day. For pediatrics, this is (12, 21) mg per day.

32 12

What is the minimum amount of time antihistamines should be stopped prior to allergy testing? 14 days 4 days 2 days Never stop these medications once started

4 days

For which client would the use of montelukast be contraindicated?​ A client whose mild asthma is well-controlled A client whose rescue inhaler stopped an attack A client who has been symptom free for 7 days A client whose asthma attack has already started

A client whose asthma attack has already started

Montelukast is prescribed to a client with asthma. During the medication therapy, which of the following laboratories should be monitored?​ Calcium and platelet count Sodium and potassium Complete blood count (CBC) ALT and AST

ALT and AST

Long-term, high dose therapy with fluticasone can result in what?​ Headaches​ Adrenal suppression​ Hoarseness​ Rebound symptoms​

Adrenal suppression

Which medication will someone with asthma use when experiencing an acute asthma attack? albuterol salmeterol montelukast theophylline

Albuterol

The nurse is providing discharge instructions to a 25-year-old client who is going home after a hospital stay from an alcohol overdose. The nurse notes in his chart that he is taking an over the counter antihistamine, diphenhydramine for his seasonal allergies. What is the priority teaching point regarding this medication for this client? Do not stop taking this medication without consulting your physician Alcohol should be avoided with this medication as it may exacerbate drowsiness and sedation Remember to take your medication prior to the start of symptoms Take with food

Alcohol should be avoided with this medication as it may exacerbate drowsiness and sedation

Antihistamines are used to treat which of the following conditions? Select all that apply. Allergic rhinitis Anaphylaxis Bronchial asthma Urticaria (hives)

Allergic rhinitis Anaphylaxis Urticaria (hives)

Which conditions are respiratory medications used to treat? Allergies and hay fever Congestive heart failure Chronic obstructive pulmonary disease (COPD) Asthma Emphysema and chronic bronchitis

Allergies and hay fever Chronic obstructive pulmonary disease (COPD) Asthma Emphysema and chronic bronchitis

After giving Jack a nebulizer treatment with albuterol, he complains of feeling "shaky" and a slight tremor in his hands is noticed. His heart rate is 102, which is elevated from what it was prior to the breathing treatment. Based on knowledge of the medications, the nurse understands Jack's reaction can be attributed to which factor? An unexpected outcome that should be reported immediately An allergic reaction to albuterol An expected side effect An indicator that he has received a dose that is too high

An expected side effect

Why is it important to take antihistamine medications before symptoms begin? It is contraindicated to take antihistamines with allergy symptoms Medications do not work after symptoms begin Antihistamines cannot combat histamine that is already present on the receptor Side effects increase after symptoms begin

Antihistamines cannot combat histamine that is already present on the receptor

Which symptoms does theophylline treat? Select all that apply. Diabetes retinopathy Asthma Bronchitis Emphysema Atherosclerosis

Asthma Bronchitis Emphysema

Which corticosteroids are used to treat respiratory conditions? Select all that apply. blephamide triamcinalone methylprednisolone prednisone

Blphamide Triamcinalone

Which drug classifications are respiratory drugs? Select all that apply. Diuretics Antibiotics Bronchodilators Expectorants Antitussives Antihistamines Decongestants

Bronchodilators Expectorants Antitussives Antihistamines Decongestants

Phosphodiesterase-4 inhibitors are used to treat which respiratory process? COPD Asthma Cough caused by seasonal allergies Bronchospasm

COPD

Any other drug that is an anticholinergic, acts on the parasympathetic nervous system, or is metabolized through the (hepatic, renal, CYP450) system will create interactions.

CYP450

Ipratropium, albuterol, and theophylline are all metabolized by which means? CYP3A4 Cellular respiration CYP450 Dialysis

CYP450

Your patient is an 18-months-old who has severe allergies to pollen. He has been prescribed Loratadine. What should the nurse's next step be? Provide instructions to the family about the new medication Ensure the medication is in liquid form for the pediatric patient Call the health care prescriber and question the order since this medication is contraindicated Give the patient his next scheduled dose

Call the healthcare provider and question the order since this medication is contraindicated

When someone has on-going, chronic respiratory disease, what other body system needs close monitoring by the nurse?​ Cardiovascular Musculoskeletal Gastrointestinal Neurological

Cardiovascular

Respirations increase when someone takes theophylline due to what system being directly stimulated? Central Nervous System Sympathetic Nervous System Respiratory Cardiovascular System

Central Nervous System

Which of the following are possible side effects of antihistamines? Select all that apply. Constipation Drowsiness Dry mouth Vision changes Vomiting Neuropathy

Constipation Drowsiness Dry mouth Vision changes

During administration of an albuterol breathing treatment, a person complains of feeling shaky. What is an appropriate response? Continue the breathing treatment but contact the prescriber for new orders so this is not an issue again Stop the breathing treatment and contact the prescriber Stop the breathing treatment and call 911 Continue the breathing treatment and inform the person this is an expected effect of the medication and it should subside

Continue the breathing treatment and inform the person this is an expected effect of the medication and it should subside

What can happen to bones as a result of long-term, high dose therapy? Select all that apply. Decreased growth in children​ Decreased bone mineral density​ Decreased inflammation in the lungs Adrenal suppression

Decreased growth in children​ Decreased bone mineral density​ Adrenal suppression

Dextromethorphan suppresses the cough reflex by which mechanism of action? Depressing the central nervous system Depressing the cough center of the brain Depressing the parasympathetic nervous system Decreasing the thickness of bronchial secretions

Depressing the cough center of the brain

What is one of the most common adverse effects that occurs with antihistamine that may result in poor use? Decreased libido Diarrhea Drowsiness Abdominal pain

Drowsiness

What side effects should the nurse monitor for in Frank after antihistamine administration? Select all that apply. Drowsiness Constipation Diarrhea Dry mouth Vision changes Hallucinations

Drowsiness Constipation Dry mouth vision changes

The nurse is giving a 37-year-old female patient an antihistamine. Which side effects will the nurse observe for in the patient? Select all that apply. Drowsiness Hypertension Tachycardia Dry mouth

Drowsiness dry mouth

Ipratropium should not be used if a person has which of the following conditions? Select all that apply. Gout Enlarged prostate Urinary retention issues Glaucoma Hypertension

Enlarged prostate Urinary retention issues Glaucoma

For which conditions is montelukast given to prevent future symptoms? Select all that apply. Exercise-induced bronchoconstriction​ Aspergillosis Allergic rhinitis​ Asthma

Exercise-induced bronchoconstriction​ Allergic rhinitis​ Asthma

Montelukast can be given to all adults and children regardless of age. ​ True False

False

Which of the following are important teaching points for albuterol? Select all that apply. Get your prescription refilled before you run out of medicine completely Use this medicine 15 to 30 minutes before you exercise, to prevent exercise-induced bronchospasm Report breathing problems that worsen quickly or if medicine is not working as well as it once did Store at room temperature away from moisture, heat, or cold temperatures Children can use this inhaler independently once taught how to use it correctly If you are unsure if your inhaler is empty, you can put it in a tub of water to see if it floats. If it floats, it is empty and a refill is needed Increase your use of this medication by one dose per day on days you exercise

Get your prescription refilled before you run out of medicine completely Use this medicine 15 to 30 minutes before you exercise, to prevent exercise-induced bronchospasm Report breathing problems that worsen quickly or if medicine is not working as well as it once did Store at room temperature away from moisture, heat, or cold temperatures

A patient with COPD has been taking ipratropium for approximately 5 years. The patient reports that she has been having some vision problems and describes blurry vision, halos, and headaches. She reports these symptoms started about 6 months ago but have become quite bothersome after her ipratropium dose was increased last. What condition might the patient have that could be aggravated by ipratropium? Prostatic hypertrophy Hypertension Glaucoma Urinary retention

Glaucoma

Theophylline increases urinary output through diuresis by increasing what process in the kidneys? Glomerular filtration Tubular reabsorption Tubular secretion Creatinine clearance

Glomerular filtration

Antihistamines compete with histamine receptor sites called H1 receptors and H2 receptors. (H1, H2) act on the gastrointestinal system and (H1, H2) act on allergic disorders.

H2 H1

(Antihistamine, Histamine) is largely responsible for causing inflammation from an allergic or hypersensitivity response.

Histamine

Which diseases or conditions would warrant caution when albuterol is prescribed? Select all that apply. History of stroke Dysrhythmias Parkinson's Multiple sclerosis Hypertension

History of stroke Dysrhythmias Hypertension

Which statement by someone taking theophylline would indicate the need for further teaching? If I consider taking any herbal medications, I will consult with the prescribing healthcare provider first I will be sure to keep my theophylline with me at all times in case I experience shortness of breath and need some relief I will swallow my pills whole and will not crush or chew them I will not change my tobacco use habits while on this medication

I will be sure to keep my theophylline with me at all times in case I experience shortness of breath and need some relief

Why is it important for albuterol to be refilled before they run out completely? In case they have an exacerbation and need to use more doses than usual In case their neighbor has a respiratory infection and may benefit from a bronchodilator In case they have an asthma attack, this will assure they will always have the medication when needed In case a busy schedule keeps them from getting to the pharmacy

In case they have an asthma attack, this will assure they will always have the medication when needed

A patient is hospitalized with a severe exacerbation of chronic obstructive pulmonary disease to receive theophylline intravenously. What therapeutic effect is expected? Increased respiratory rate Increased heart rate Increased sputum production Increased ease of breathing

Increased ease of breathing

What do leukotrienes cause? Select all that apply. Bronchodilation Inflammation Bronchoconstriction Vasoconstriction Mucus

Inflammation Bronchoconstriction Mucus

Methylprednisolone is a corticosteroid that can be given by which route? Select all that apply. Buccal Transdermal Intrasynovial Oral Intramuscular

Intrasynovial Oral Intramuscular

By which routes can corticosteroids be administered? Intravenously Trandermal Buccal Inhalation Oral

Intravenously Inhalation Oral

What is the action of an antihistamine medication? It gets other cells to respond and release more antihistamine It binds to the cell instead of the histamine and stops the inflammatory process It damages the histamine receptor sites to prevent future allergies It is released by an over reactive cell in response to an antigen

It binds to the cell instead of the histamine and stops the inflammatory process

What effect does tobacco have on the amount of theophylline in the bloodstream? It decreases the amount It increases the amount It eliminates it completely It does not impact the amount

It decreases the amount

Which of the following would be goals in the treatment of a patient with asthma? Select all that apply. Retention of secretions Identification of potential complications Maintenance of airway patency Verbalization of misunderstanding of causes and therapeutic management regimen Absence or reduction of congestion

Maintenance of airway patency Expectoration of secretions Absence/reduction of congestion with breath sounds clear, respirations noiseless, improved oxygen exchange Verbalization of understanding of causes and therapeutic management regimen Demonstration of behaviors to improve or maintain a clear airway Identification of potential complications and how to initiate appropriate preventive or corrective actions​

Which factor increases the risk of interactions when medications are taken with fluticasone?​ Overstimulation of the autonomic nervous system Loss of medication through first-pass metabolism Overstimulation of the adrenal glands Metabolism of medications through the CYP450 enzyme system

Metabolism of medications through the CYP450 enzyme system

From the list below, select all of the symptoms that are signs of theophylline toxicity. Severe Metabolic Acidosis Mild Metabolic Acidosis Severe Nausea Severe and Protracted Vomiting High or Low Calcium Lethargy Palpitations Syncope Low Potassium, Phosphate, and/or Magnesium Seizures Tremors Hyperkalemia

Mild Metabolic Acidosis Severe Nausea Severe and Protracted Vomiting High or Low Calcium Palpitations Syncope Low Potassium, Phosphate, and/or Magnesium Seizures Tremors

Which of the following assessment findings indicate that treatment by respiratory drugs are effective? Select all that apply. Mobility of secretions Absence or reduction of congestion Maintenance of airway patency Continued shortness of breath

Mobility of secretions Absence or reduction of congestion Maintenance of airway patency

Select what words indicate his COPD is not well controlled on current regimen.

Moderate respiratory distress marked by positional breathing and retractions, mildly distended neck veins, and inspiratory and expiratory wheezing indicate an active COPD process that is not well maintained by current treatment regimens.

Antihistamines are primarily used for which of the following conditions? Select all that apply. Nasal allergies Bronchial asthma Allergic reaction treatment Motion sickness

Nasal allergies Allergic reaction treatment Motion sickness

What are signs of adrenal insufficiency that should be monitored when someone switches from systemic corticosteroids to inhaled corticosteroids such as fluticasone? Select all that apply. Nausea​ Hyperglycemia Hypotension​ Vomiting​ Fatigue​ Hypertension​ Weakness​ Anorexia​ Hypoglycemia​

Nausea​ Hypotension​ Fatigue​ Weakness​ Anorexia​ Hypoglycemia​

In which populations of people should theophylline be used with caution? Select all that apply. Neonates Infants Older adults Children Adolescents Adults

Neonates Infants Older adults

In which body systems does albuterol create both therapeutic effect and side effects? Select all that apply. Nervous Cardiovascular Skeletal Respiratory

Nervous Cardiovascular Skeletal

Due to the anticholinergic effect of antihistamines, what conditions can be treated with these medications? Select all that apply. Parkinson's disease Vertigo Motion sickness Hypertension

Parkinson's disease Vertigo Motion sickness

Caution should be used in which patient populations with fluticasone?​ Select all that apply. Patients with active untreated infections​ Patients with diabetes mellitus​ Patients with glaucoma​ Patients with cataracts​

Patients with active untreated infections​ Patients with diabetes mellitus​ Patients with glaucoma​

By what means does omalizumab work? Preventing release of mediators that lead to allergic responses Increasing the release of mediators that lead to allergic responses Activating interleukin-5 receptors to block immune response to allergens Eliminating the response of IgE in response to allergens

Preventing release of mediators that lead to allergic responses

What are the treatment goals of montelukast? Select all that apply.​ Eliminate symptoms of seasonal allergic rhinitis Prevention of and reduction in symptoms of asthma Decrease in severity of allergic rhinitis Exacerbate exercise-induced bronchoconstriction Prevention of exercise-induced bronchoconstriction

Prevention of and reduction in symptoms of asthma Decrease in severity of allergic rhinitis Prevention of exercise-induced bronchoconstriction

What substances should either not be taken with theophylline or closely monitored? Select all that apply. Riociguat Echinacea Vitamin D Grapefruit St John's Wort

Riociguat St John's Wart

What is the most important information a patient needs to know about ipratropium inhalation of the information listed below? Select all that apply. If you are using this medicine with a nebulizer, space your doses 3 to 4 hours apart Keep in the refrigerator Seek medical attention if breathing problems get worse quickly, or if medications don't seem to by working as well Do not get this medicine in your eyes, especially if you have glaucoma

Seek medical attention if breathing problems get worse quickly, or if medications don't seem to by working as well Do not get this medicine in your eyes, especially if you have glaucoma

Which of the following are important teaching points for ipratropium? Select all that apply. Seek medical attention if your breathing problems get worse quickly Exercise should be avoided while taking this medication Do not mix this medication with another nebulized medication This medicine may cause blurred vision and may impair your reactions The canister may explode if it gets too hot

Seek medical attention if your breathing problems get worse quickly This medicine may cause blurred vision and may impair your reactions The canister may explode if it gets too hot

Valine is a 24-year-old nursing student recently diagnosed with asthma. Valine notices that her chest feels tight, she feels dizzy, and she can't catch her breath after running up a flight of stairs. Which classification of her prescribed respiratory medication should she use now? Inhaled corticosteroids Long-acting beta2-agonists Mast cell stabilizers Short-acting inhaled beta2-agonists

Short-acting inhaled beta2-agonists

Which bronchodilator should be used as a rescue inhaler and not as a daily medication to prevent shortness of breath? Long-acting inhaled beta2-agonsits Inhaled corticosteroids Mast cell stabilizers Short-acting inhaled beta2-agonists

Short-acting inhaled beta2-agonists

Someone experiencing bronchospasm will report one or more of which symptoms listed below? Select all that apply. Shortness of breath Productive cough Wheezing Choking Dry cough

Shortness of breath Wheezing Dry Cough

Select the words that indicate Jack's COPD is a chronic condition.

Shortness of breath, chronic cough, a productive cough with yellow to brownish sputum the last few years, mildly distended neck veins, barrel-shaped chest, and lung sounds that are equal bilaterally but diminished to mid and lower fields

Which products, when taken with theophylline, can decrease theophylline's serum drug levels? Select all that apply. Energy Drinks St. John's Wort Peppermint Oil Tobacco

St John's Wart Tobacco

Which of the following conditions commonly have drugs prescribed that can interact with ipratropium? Select all that apply. Alzheimer's and similar dementias Muscular dystrophy Stomach problems, motion sickness, or irritable bowel syndrome Depression, anxiety, mood disorders, or mental illness Parkinson's disease Overactive bladder

Stomach problems, motion sickness, or irritable bowel syndrome Depression, anxiety, mood disorders, or mental illness Parkinson's disease Overactive bladder

What health promotion activities will the nurse encourage Jack to complete? 60 minutes of cardiovascular exercise daily Stop smoking Receive the flu and pneumonia vaccine as scheduled Decrease his dietary fat intake

Stop smoking Receive the flu and pneumonia vaccine as scheduled

What information should the nurse provide to Frank regarding administration of antihistamine medications? Select all that apply. Stop taking antihistamines four (4) days before an allergy appointment Antihistamines work best when administered prior to the anticipated exposure of an allergen​ Lower doses may be required for children and older adults Take with food

Stop taking antihistamines four (4) days before an allergy appointment Antihistamines work best when administered prior to the anticipated exposure of an allergen​ Take with food

When beginning treatment with a beta-agonist bronchodilator, clients should report which side effect? Tachycardia Sedation Non-productive cough Hypoglycemia

Tachycardia

Frank is being discharged and the nurse goes to his room to provide him with discharge instructions. Discharge instructions for a patient going home on antihistamines should include which of the following? Select all that apply. Take your medicine with food You may be drowsy at first, so be careful when driving as you get used to your medications Do not take your medications with food Remember to stop taking your medication 4 days before your next allergy appointment You may chew gum or drink extra fluids to counteract the dry mouth side effect if it occurs

Take your medicine with food You may be drowsy at first, so be careful when driving as you get used to your medications Remember to stop taking your medication 4 days before your next allergy appointment You may chew gum or drink extra fluids to counteract the dry mouth side effect if it occurs

What can happen to the mouth if the mouth is not rinsed after using an inhaled corticosteroid and teeth are not well cared for? Select all that apply. Teeth can have over build up of enamel due to topical steroid effect Teeth can become discolored Dental carries/cavities can occur Candidiasis/yeast infection can occur in the mouth

Teeth can become discolored Dental carries/cavities can occur

What is the major advantage to using inhaled corticosteroids over systemic corticosteroids? They do not cause nausea They are easier to administer Their action is limited to the lungs only Their action is more topical and focused on the lungs

Their action is more topical and focused on the lungs

After several doses of theophylline, the client starts to become restless and complains of palpitations. It is determined that the client is experiencing theophylline toxicity in which of the following lab values? Theophylline level of 25mcg/ml Theophylline level of 5 mcg/ml Theophylline level of 10mcg/ml Theophylline level of 20mcg/ml

Theophylline level of 25mcg/ml

For what reason do the heart and lungs often experience complications at the same time? They are both controlled by the medulla oblongata They share a common goal of oxygenating the blood They are close together in the body They are both controlled by the cerebellum

They share a common goal of oxygenating blood

Why is it important a patient either rinses their mouth out or brushes their teeth after using an inhaler? Select all that apply. To stay hydrated To prevent fungal infections To spread the medication along the oropharynx So they have fresh breath To prevent dental carries

To prevent fungal infections To prevent dental carries

Why should the mouth be rinsed after using a glucocorticoid inhaler? To prevent oral candidiasis To prevent gingivitis To prevent oral herpes To prevent gum hyperplasia

To prevent oral candidiasis

Which of the following would indicate client understanding of respiratory management drug regimens? Select all that apply. Verbalized understanding that all inhalers are to be used on an as needed basis Verbalized understanding of causes and therapeutic management regimen Identified potential complications and how to initiate appropriate preventive or corrective actions Demonstrated behaviors to improve or maintain clear airway

Verbalized understanding of causes and therapeutic management regimen Identified potential complications and how to initiate appropriate preventive or corrective actions Demonstrated behaviors to improve or maintain clear airway

The nurse is caring for a 19-year-old male patient who has been newly diagnosed with asthma. The following medication order has been prescribed by the healthcare provider. Albuterol 90mcg 2 puffs as need for shortness of breath Formoterol 160/4.5 mcg 1 puff bid The nurse is charged with providing medication administration teaching. Please place the instruction steps in chronological order.

Wash your hands Exhale completely Administer first puff of albuterol Wait 1-2 minutes Administer second puff of albuterol Wait 2-5 minutes Administer 1 puff of formoterol Brush your teeth

Which second-messenger neurotransmitter is involved in the action of ipratropium? histamine dopamine acetylcholine epinephrine

acetylcholine

Anticholinergic drugs, such as ipratropium and tiotropium, work by blocking (dopamine, GABA, acetylcholine), a neurotransmitter, to prevent bronchial (constriction, dilation, convolution) and narrowing of the airways, which indirectly facilitates bronchodilation.

acetylcholine constriction

Leukotriene receptor agonists (LTRAs) are a(n) (primary, add-on) medication to other treatment regimens and not a (primary, add-on, treatment plan.​

add-on primary

Which of the medications listed should be used for rescue treatments? theophylline ipratropium fluticasone albuterol

albuterol

Leukotrienes are chemicals your body releases from leukocytes when you breathe in a/an (virus, bacteria, allergen)

allergen

Contraindications for someone taking montelukast is a/an (tolerance, allergy) to the drug itself or the class as a whole.

allergy

What drugs compete for specific receptor sites with histamine? Antihistamines Antacids Antivirals Antiemetics

antihistamines

Mast cell stabilizers are rarely used, and when indicated they are prescribed for exercise-induced (COPD, emphysema, asthma, allergies.)

asthma

Albuterol acts by targeting specific (beta-1 adrenergic, beta-2 adrenergic) receptors in the lungs to relax (skeletal, smooth muscles) of the airways.

beta-2 adrenergic smooth

Each cell has histamine 1 (H1) receptor sites in which the histamine will (destroy, bind) and then cause the cell to (destruct, react.)

bind react

Phosphodiesterase type 4 (PDE4) is an enzyme that is mainly present in immune, epithelial, and ________ cells that ________ inflammation and epithelial integrity.​

brain modulates

Albuterol is a bronchodilator taken to treat (bronchodilation, bronchospasm).

bronchospasm

Theophylline is metabolized into (sugar, caffeine) in the body.

caffeine

Antihistamines (can, cannot) combat histamine that is already present on the receptor.

cannot

Which of the drugs below should be used with caution when also taking montelukast? Select all that apply. echinacea​ phenobarbital​ carbemazepine​ St. John's Wort​ phenytoin​

carbamazepine​ St. John's Wort​ phenytoin​

In addition to a good physical assessment by the nurse, a (complete medical history, a complete medication profile) can also be helpful​.

complete medical history

Antihistamines should be discontinued for at least four (4) (days, weeks) before allergy testing.

days

Which of the following medications is contraindicated to administer with fluticasone?​ clarithromycin​ atazanavir​ ketoconazole​ desmopressin​

desmopressin

Albuterol causes (dilation, constriction) in the respiratory system and (dilation, constriction) in the cardiovascular system.

dilation constriction

With knowledge of the suffix for antihistamines, which of the following are antihistamines? Select all that apply. diphenhydramine loratadine metoprolol hydrochlorothiazide fexofenadine

diphenhydramine loratadine fexofenadine

Which of the following emotions can often accompany shortness of breath? Select all that apply. Fear Sadness Stress Anxiety

fear stress anxiety

Antihistamines are drugs that compete for specific receptor sites with (allergens, histamine.)

histamine

(Antihistamine, Histamine) is released by an over reactive cell in response to an antigen. The overactive cell tries to get other cells to respond as well and releases (antihistamine, histamine.) (Antihistamine, Histamine )medications compete with the (antihistamine, histamine) for the receptor site. The (antihistamine, histamine) binds to the cell instead and stops the inflammatory process.

histamine histamine antihistamine histamine antihistamine

What is the therapeutic effect expected with ipratropium? Improved breathing through bronchodilation Improved breathing through vasodilation Improved breathing through bronchospasm Improved breathing through vasoconstriction

improved breathing through bronchodilation

Fluticasone is an __________ that _____________ to improve breathing.

inhaled corticosteroid deceases inflammatory response

The nurse is preparing to administer the first dose of montelukast to a client experiencing an exacerbation of asthma following surgery. Which allergies alert the nurse to hold the medication and contact the prescribing health care provider? Select all that apply.​ ampicillin​ zolpidem aspirin​ lactose cellulose​ xylitol

lactose cellulose

Montelukast is a(n) (inhaled corticosteroid, leukotriene receptor antagonist, phosphodiesterase-4 inhibitor, monoclonal antibody antiasthmatic) that stabilizes (cellular membranes, prevents mucus, decreases inflammatory response, prevents coughing and excess mucus) to improve breathing.

leukotriene receptor antagonist that decreases inflammatory response

What medications can ipratropium be mixed with in a nebulizer? Select all that apply. levalbuterol albuterol metoprolol metaproterenol labetalol

levalbuterol albuterol metaproterenol

(diphenhydramine, loratadine) is contraindicated in children under 2 years old.

loratadine

Which of the following antihistamine is a contraindication in children under 2 years old? hydroxyzine promethazine diphenhydramine loratadine

loratadine

Ipratropium (may, may not) be used to treat an asthma exacerbation but (should, should not) be used as a rescue inhaler.

may should not

Caffeine stimulates the central nervous system in the (brain stem, medulla) which (decreases, increases) the respiratory rate.

medulla increases

Fluticasone inhalation powders should not be used by patients with a severe (peanut, milk protein) allergy.​

milk protein

Fluticasone works by inhibiting what substances in the body? ​ Mineral corticoids​ ​Glucocorticoids​ Adrenal corticoids​ Multiple inflammatory cytokines​

multiple inflammatory cytokines

What is the only route montelukast is given?​ Subcutaneous ​ Oral​​ Intravenous Intramuscular

oral

When taken in the (oral, inhaled) preparation, albuterol has a (longer, shorter, equal) onset and (longer, shorter, equal) half-life than comparable (inhaled, intravenous) albuterol preparations.

oral longer longer inhaled

Which branch of the autonomic nervous system is affected by ipratropium? Sympathetic Parasympathetic Central Empathetic

parasympathetic

Roflumilast is a(n) _______________ that decreases inflammatory response and ____________________ to improve breathing. ​

phosphodiesterase-4 inhibitor prevents coughing and excess mucus

Xanthines are used for the (relief, prevention) of asthmatic symptoms and COPD, not for the (relief, prevention) of acute asthma attacks.

prevention relief

(Confusion, Restlessness) is often the first sign of hypoxia a nurse can notice, so frequent assessment before, during, and after drug treatment is needed.​

restlessness

Which drugs may decrease the effects of montelukast? Select all that apply. St. John's Wort​ carbamazepine rifampin phenobarbital​​ echinacea phenytoin

rifampin phenobarbital​​

Frank is beginning antihistamine medications. What does the nurse identify from his assessment related to the primary indication for antihistamine medication use? Nothing Severe seasonal allergies Parkinson's disease Vertigo

severe seasonal allergies

Albuterol is a (long-acting, short-acting) beta agonist which is an important characteristic that helps determine when and how it is used.

short-acting

An asthmatic 15-year-old is playing baseball and begins to have chest tightness and shortness of breath. Which type of inhaler should be used at this time? Mast Cell Stabilizer Short-acting beta agonist Long-acting beta agonist Leukotriene receptor antagonist

short-acting beta agonist

Riociguat should be (monitored, stopped) when someone is taking theophylline and dilantin should be (monitored, stopped.)

stopped monitored

A pediatric client with asthma has just received omalizumab. Which physical assessment finding indicates the client might be suffering a life-threatening side effect? ​ Headache Joint pain Nausea Swelling of the tongue

swelling of the tongue

Long-acting Beta2 Agonists actions and side effects of beta-adrenergic agonist (beta-blockers) will mimic the (parasympathetic, sympathetic) nervous system.

sympathetic

Exactly how fluticasone works is (well documented, unknown.)​

unknown

Due to the anticholinergic effects of antihistamines, what other issues from Frank's chart may be an indication for use in addition to seasonal allergies? Select all that apply. Vertigo Age-related issues Parkinson's disease Normal vital signs

vertigo Parkinson's disease