Chapter 37 Evolve Questions

Which statement by a client best indicates an understanding of the teaching on flunisolide (AeroBid)? A. "I will rinse my mouth with water after each use." B. "I will wash the plastic inhaler casing once a month." C. "I will take two puffs to treat an acute asthma attack." D. "I will not use my albuterol inhaler while I am taking AeroBid."

"I will rinse my mouth with water after each use." Flunisolide is an inhaled corticosteroid . Rinsing the mouth immediately after each use of the inhaler or nebulizer will help prevent oral candidal infections. It is not used to treat an acute asthma attach and should be taken with the client's bronchodilator medications. The plastic inhaler casing is washed in warm, soapy water every week.

The nurse performs discharge teaching with a client who is prescribed the anticholinergic inhaler ipratropium bromide (Atrovent). Which statement by the client indicates to the nurse that teaching has been successful? A. "I will not drink grapefruit juice while taking this drug." B. "I may gain weight as a result of taking this medication." C. "This inhaler is not to be used alone to treat an acute asthma attack." D. "Nausea and vomiting are common adverse effects of this medication."

"This inhaler is not to be used alone to treat an acute asthma attack" Although ipratropium works to prevent bronchoconstriction and thus secondarily leads to bronchodilation, a direct-acting bronchodilator is needed to treat an acute asthma attack.

Client teaching regarding the use of leukotriene receptor antagonists (LTRAs) drugs such as zafirlukast (Accolate) would include which statement by the nurse? A. "It will take about 3 or 4 weeks before you notice a therapeutic effect." B. "Take the medication when you are short of breath and begin wheezing." C. "This medication works by preventing the inflammation that causes your asthma attack." D. "Increase fiber and fluid in your diet to prevent the common adverse effect of constipation."

"This medication works by preventing the inflammation that causes your asthma attack." LTRAs drugs block the inflammatory response of leukotrienes and this the trigger for asthma attacks. Response to these drugs is usually noticed within 1 week. They are not used to treat acute asthma attacks. Diarrhea, not constipation, is a common adverse effect of montelukast and zafirlukast.

Which statement by the nurse should be included when teaching a client about the proper use of metered-dose inhalers? A. "After you inhale the medication once, repeat until you obtain relief." B. "Wait 1 to 2 minutes before you take a second puff of the same drug." C. "Make sure that you puff out air several times after you inhale the medication." D. "Hold the inhaler in your mouth, take a deep breath, and then compress the inhaler."

"Wait for 1 to 2 minutes before you take a second puff of the same drug." If a second puff of the same drug is ordered, instruct the client to wait 1 to 2 minutes between puffs. If a second type of inhaled drug is prescribed, instruct the client to wait 2 to 5 minutes between the medications or to take as prescribed.

The nurse is providing care to a client prescribed a nonselective adrenergic agonist bronchodilator. Which condition documented in the client's medical history would alert the nurse to question this prescription?

Coronary Artery disease Nonselective adrenergic agonist bronchodilators stimulate beta 1 receptors in the heart and beta 2 receptors in the lungs. Stimulation of beta 1 receptors can increase heart rate and contractility, increasing oxygen demand. This increased oxygen demand may lead to angina or myocardial ischemia in clients with coronary artery disease.

Before administering an LTRA medication, the nurse would assess the client for allergies to which substance? (Select all that apply.) A. Latex B. Lactose C. Cellulose D. Povidone E. Chlorhexidine

Lactose, Cellulose, and Povidone Allergies to povidone, lactose, titanium dioxide, or cellulose derivatives are important to note because these are inactive ingredients in LTRAs.

Which laboratory value would the nurse assess before administering zafirlukast (Accolate) to a client?

Liver enzyme Because use of zafirlukast may lead to liver dysfunction, liver enzyme levels should be monitored regularly, especially early in the course of therapy.

A nurse is providing education to a client taking two different bronchodilator medications. The nurse identifies which characteristic as the advantage of salmeterol (Serevent) over other beta2 agonists such as albuterol (Proventil)?

Longer duration of action Salmeterol has a longer duration of action, requiring the client to use it only twice a day instead of three or four times a day with albuterol.

Which herbal product, when taken with theophylline, can decrease theophylline's serum drug levels?

St. John's Wort St. John's wort has been shown to enhance the rate of theophylline metabolism, thus decreasing serum levels.

Discharge teaching to a patient receiving a beta-agonist bronchodilator should emphasize reporting which side effect?

Tachycardia A beta-agonist bronchodilator stimulates the beta receptors of the sympathetic nervous system, resulting in tachycardia, bronchodilation, hyperglycemia, and increased alertness.

The nurse receives laboratory values for a client with a theophylline level of 14 mcg/mL. How does the nurse interpret this theophylline level?

Therapeutic the therapeutic theophylline level is 10 to 20 mcg/mL

What is the role of corticosteroids in the treatment of acute respiratory disorders?

They decrease inflammation Corticosteroids can suppress the immune system. They do not directly affect bronchodilation but rather prevent bronchoconstriction as a response to inflammation.