Chapter 33: Drug Therapy for Asthma and Bronchoconstriction

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? "We need to let the health care provider know if the medicine gives me a headache or makes me dizzy." "This is a new kind of asthma medication." "This medication is safe for kids like me." "I need to take the medication when I start to have problems breathing."

"I need to take the medication when I start to have problems breathing." Rationale: These drugs are not indicated for the treatment of acute asthmatic attacks because they do not provide any immediate effects on the airways. Patients need to be cautioned that they should not rely on these drugs for relief from an acute asthmatic attack. The remaining statements are all accurate information regarding this classification of medications.

The nurse is providing education to a client who has been prescribed theophylline. The nurse interprets what client statement as a sign of successful teaching? "I can expect this drug to have a sedating effect." "I should avoid beverages that contain caffeine." "I should limit my fluid intake to 1,000 mL a day." "I will need to increase my intake of foods high in potassium."

"I should avoid beverages that contain caffeine."

Which statement, made by a client diagnosed with chronic obstructive pulmonary disease (COPD), demonstrates an understanding of the cause of this respiratory disorder? "I have a bacterial lung infection that doesn't respond to antibiotics." "It's a genetic disorder that I've had since I was born." "Smoking a pack of cigarettes a day for 30 years makes it hard to get air in." "My allergies trigger a chronic response in my lungs."

"Smoking a pack of cigarettes a day for 30 years makes it hard to get air in."

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 The standard dose of aminophylline A drug other than aminophylline Phenytoin intravenously

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 Pancreatic insufficiency Renal insufficiency Pituitary insufficiency

Adrenal insufficiency

A male client presents with symptoms of bronchospasm that occurred during a birthday party for his grandson. What medication would the nurse expect the health care provider to give the client?

Albuterol

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

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 Omalizumab Salmeterol Epinephrine

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

Cigarette smoking

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

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?

Contact the care provider and inform him or her that the client has toxic theophylline levels.

Shane, a 25-year-old man, is diagnosed with asthma. He began an albuterol MDI 2 weeks ago. He reports that his symptoms persist in spite of using albuterol MDI as prescribed. What advice should the nurse give the client? Contact the health care provider to obtain adjunctive medications. Contact the health care provider to obtain an increased dosage of albuterol. Use the MDI more often. Clean the MDI thoroughly on a regular basis.

Contact the health care provider to obtain adjunctive medications.

A client who has chronic bronchial asthma has had a mast cell stabilizer prescribed. What drug would the provider prescribe? Cromolyn Ipratropium Isoetharine Aminophylline

Cromolyn

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? Montelukast Cromolyn Calfactant Triamcinolone

Cromolyn

A client with asthma has been prescribed an anti-inflammatory medication. How does an anti-inflammatory drug reduce this client's bronchoconstriction?

Decreasing airway hyperreactivity to stimuli

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? Caffeine can aggravate the drugs used to treat asthma Most natural products are less toxic or more potent than traditional asthma medications Delays in appropriate treatment can have serious, even fatal, consequences Natural products decrease the adverse effects associated with adrenergic bronchodilators

Delays in appropriate treatment can have serious, even fatal, consequences

A nurse is teaching a client diagnosed with asthma about the disease. Which should the nurse instruct the client to avoid because it may cause bronchoconstriction?

Extremely cold temperatures

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? Montelukast Zileuton Fluticasone Zafirlukast

Fluticasone Rationale: Fluticasone (Flonase) is a topical corticosteroid for inhalation.

Which would the nurse identify as being involved with asthma? Hyperactive airways Alveolar collapse Acute infection Progressive loss of lung compliance

Hyperactive airways

A nurse is providing health education to a client recently diagnosed with asthma and prescribed albuterol and ipratropium. Which of the client's statements suggests a need for clarification by the nurse?

I'll keep taking my medications until I'm not experiencing any more symptoms."

The nurse is caring for a client with chronic obstructive pulmonary disease. The plan of care will focus on what client problem? Risk for aspiration Adverse effects of medication therapy Activity intolerance Lack of patent airway

Lack of patent airway

What is the most effective method used to monitor clients with asthma that they can use at home? Trough-flow monitor Peak-flow monitor Manometer Incentive spirometer

Peak-flow monitor

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.) Pollutants Allergens Warm weather Exercise

Pollutants Allergens Exercise

A client, experiencing respiratory distress related bronchi constriction, will benefit from what therapeutic action provided by anticholinergic medication therapy? Relaxation of smooth muscle Enhancement of alveolar expansion Decrease in the production of leukotrienes D4 and E4 Reduction of the inflammatory response

Relaxation of smooth muscle

A 42-year-old male client has a history of smoking for 20 years. The client states he is feeling fine and asks why stopping smoking is necessary. What information might the nurse share with the client about smoking?

Smoking decreases the size of the tubes leading to the lungs.

The nurse is caring for a 38-year-old client who is beginning treatment with albuterol. Which should the nurse identify as a potential adverse effect of the drug?

Tachycardia

What action by the client would indicate that the client understands how to use an inhaler?

The client holds his or her breath for several seconds after compressing the canister.

A client has been prescribed an inhaled steroid for the treatment of asthma. What information should the nurse include when providing medication education to the client? Select all that apply.

The medication is not intended to treat an acute asthma attack. Promptly report a fever or any other indication of infection to your health provider. Abruptly stopping any previously prescribed systemic steroid could cause an adrenal insufficiency.

A 70-year-old client is being treated for chronic obstructive pulmonary disease (COPD) with theophylline. What will be a priority assessment by the nurse?

Use of nicotine

Respiratory symptoms are treated with many types of drugs, including

anti-inflammatory agents.

What medical condition is likely to be exacerbated by the medication therapy associated with asthma? gastroesophageal reflux disease (GERD) urinary retention cataracts dermatitis

gastroesophageal reflux disease (GERD) Rationale: Asthma, may aggravate GERD, because antiasthma medications that dilate the airways also relax muscle tone in the gastroesophageal sphincter and may increase acid reflux. The relationship between asthma medications and the other options is not supported by research data.

A client has been diagnosed with chronic obstructive pulmonary disease. The client has been prescribed bronchodilators by nebulizer for home use. The nurse should teach the client to: sit in a fully upright position when administering the medication. take the exact number of puffs that have been prescribed. keep an extra oxygen tank on hand for propelling the medication. gargle with an alcohol-based mouthwash after each dose.

sit in a fully upright position when administering the medication.