Chapter 55

Inhalation

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

Increased serum theophylline

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

Relaxation of smooth muscle

A client, experiencing respiratory distress related bronchi constriction, will benefit from what therapeutic action provided by anticholinergic medication therapy?

Adrenal insufficiency

A female client is prescribed systemic corticosteroids for her asthma. The nurse knows that the client is at risk for what problem?

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?

rebound bronchoconstriction.

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

Cigarette smoking

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

Peanuts

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?

9:30 AM

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?

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)?

Mix the drug with saline.

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

15 mcg/mL

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

"I need to shake the inhaler well before taking the medication."

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?

15 minutes prior to exercising

The nurse instructs a patient who is using albuterol for exercise-induced bronchospasm to use the inhaler at which time?

Tachycardia

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

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?

ipratropium

The nurse should be aware that concomitant use of what drug is contraindicated during tiotropium therapy?

Beta2-adrenergic agonist

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

Slow-reacting substance of anaphylaxis

When describing the action of mast cell stabilizers, which of the following would the nurse include as being inhibited?

Global Initiative for Asthma (GINA)

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

Decreased eosinophil migration

Which of the following effects would result from the action of montelukast?

Beta-2 selective adrenergic agonist

A client is experiencing an acute asthmatic attack. Which agent would be most effective?

Intratracheal

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

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

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?

"I need to take the medication when I start to have problems breathing."

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?

Have the resident rinse his or her mouth after each dose of the drug.

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?

Ineffective breathing pattern

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?

Beractant

Which of the following would a nurse identify as a surfactant?

They act locally to decrease release of inflammatory mediators

Why are inhaled steroids used to treat asthma and COPD?

The medication should be taken on an empty stomach.

A client diagnosed with asthma has been prescribed a leukotriene receptor antagonist. What information should the nurse include when discussion medication instructions with this client?

A 65-year-old male with asthma

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?

gastroesophageal reflux disease

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?

Using a spacer

A client is being assessed by the home care nurse for the appropriate use of a metered-dose inhaler. Instructions concerning which intervention will assist a client in the proper use of the device?

Chocolate

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

30 minutes before engaging in exercise

A client is prescribed salmeterol as treatment for exercise-induced asthma. The nurse would instruct the client to use the inhaler at which time?

Monitoring respirations for bilateral chest movement

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?

has a high coffee intake.

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

Albuterol causes relaxation of the bronchial smooth muscles.

Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?

Nervousness

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?

Inhaled corticosteroid agents reduce airway inflammation.

The nurse is providing education to a client with asthma on the therapeutic action of inhaled corticosteroid agents. How will the nurse describe the action?

Mold Exercise Allergens Cigarette smoke

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.

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

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?

Coffee

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?

Albuterol first, wait five minutes and then follow with flunisolide

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?

Rinse mouth with water after each use.

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?