lower respiratory disorders- med surg

The nurse is teaching a patient with chronic obstructive pulmonary disease about the drug ipratropium (Atrovent). Which statement by the patient indicates a need for further instruction?

"If I suddenly have difficulty getting my breath I will use this medicine immediately."

Which instruction does the nurse give to a patient who is prescribed both tiotropium bromide (Spiriva) and fluticasone-salmeterol (Advair Diskus)?

"Use the Spiriva, wait several minutes, and then use the Advair."

During a respiratory assessment of a patient the nurse noted the patient was coughing frequently and the oxygen sat was less than 90%. Which of the following lower respiratory diseases/ conditions could be the cause of these findings? SATA

- Asthma - Smoking - Pneumonia - Chronic obstructive pulmonary disease

Before initiating anithistamine medications the nurse knows that the patient's history should be checked for which of the following? SATA

- Glaucoma - Urinary retention - Asthma

A home health nurse is reinforcing teaching to a client who has active TB and is following a medication regimen that includes a combination of isoniazid, rifampin, pyrazinamide, and ethambutol. Whick of the following client statements indicate understanding? SATA

- I will wash my hands each time that I cough - I will wear a mask when I am in a public area

Therapy for lung cancer may consist of which treatments? (Select all that apply.)

- Lobectomy - Brachytherapy - Chemotherapy

A nurse is collecting data from a client following a gunshot wound to the chest. For which of the following findings should the nurse monitor to detect a pneumothorax?

- Tachypnea - Deviation of the trachea - Pleuritic pain

A nurse is collecting data from a client who is experiencing an acute asthma attack. Which of the following findings indicates that the client's respiratory status is declining? SATA

- Wheezing - retraction of sternal muscles - ineffective cough

The nurse is preparing to administer the beta adreneric broonchodilator albuterol but first performs which of the following preassessments on the patient? SATA

- checks for a history of glaucoma, DM, or peptic ulcer disease. - performs an assessment of the baseline mental status - asks about concurrent use of antihistamines of nasal decongestants

A nurse in the emergency department is collecting data from a client who has sustained multiple rib fractures and has a flail chest. Which of the following findings should the nurse expect? SATA

- cyanosis - hypotension - dyspnea - paradoxical chest movement

The expectorant guaifenesin (robitussin) used for relief of conditions such as the common cold and bronchoitis, works by which actions? SATA

- decreasing mucus viscosity - promoting ciliary action

After the administeration of inhaled steroid medications, the nurse instructs the patient to do which of the following? SATA

- rinse the mouth with water and spit out the water. - use the bronchodilator first before the inhaled steroid when both were ordered.

During an eval of a patient who came into the clinic complaining of SOB and increased sputum production, the nurse asks the patient for further information by which of the following statements? SATA

- tell me about your cough. does it wake you at night? - what activities would you say make you short of breath - when you cough up sputum what color is it - is there anyone at home to help you

A nurse is preparing to administer an initial dose of prednisone to a client who has COPD. The nurse should monitor for which of the following adverse effects of this medication? SATA

-Hypokalemia - Fluid retention - Black tarry stools

A nurse is providing information about TB to a group of clients at a local community center. Which of the following manifestations should the nurse include? SATA

-persistent cough - fatigue - night sweats - purulent sputum

Which patient must be observed closely when taking acetylcysteine (Mucomyst)?

A 30-year-old with quadriplegia

A patient is admitted to the emergency department after overdosing on acetaminophen (Tylenol). The nurse anticipates that the physician will order which medication to treat this patient?

Acetylcysteine (Mucomyst)

With asthma, the early phase of an acute episode begins when triggers such as allergens cause which response?

Activation of the inflammatory process constricting the airways

The nurse is preparing to administer both a bronchodilator and a steroid by inhalation and knows which medication should be administered first?

Administer the bronchodilator first

When cromolyn sodium is prescribed for patients with severe allergic rhinitis, the nurse knows this drugs will have which of the following effects?

Antiinflammatory

Which drug class will most likely help a patient reporting insomnia as a result of a persistent cough?

Antitussive

Chronic obstructive pulmonary disease (COPD) is characterized as a combination of which conditions?

Asthma, chronic bronchitis, and emphysema

A nurse is assisting with the care of a client who has an SaO2 of 91% exhibits audible wheezes, and is using accessory muscles when breathing. Which of the following classes of medications should the nurse expect to administer?

Beta 2 agonist

A 78-year-old resident with asthma is suddenly exhibiting signs of dyspnea, use of accessory muscles, and audible expiratory wheezing. A pharmacologic approach to assist with the relief of acute symptoms would be administration of which type of medication?

Beta2-receptor agonist

The nurse knows that intranasal corticosteroids are used for short periods to treat seasonal allergies, and explains to the patient that which of the following needs to be done before application?

Blow nose prior to administration

A nurse observes that a patient with chronic obstructive pulmonary disease (COPD) has increased dyspnea over the past 12 hours, a heart rate of 98 beats/min, and edema in the lower extremities. What is the initial nursing intervention?

Contact the health care provider to report the change of condition.

Which is a useful monitoring practice for a patient with moderate to severe persistent asthma?

Daily peak flow monitoring

Which antitussive has a combination of antihistamine and antitussive properties?

Diphenhydramine (Diphen)

A nurse is collecting data from a client who has a history of asthma. Which of the following factors should the nurse identify as a risk for asthma?

Environmental allergies

The nurse is reviewing objective data from the physical examination of a patient with COPD. Which finding does not fit the usual pattern seen with COPD?

Even and unlabored without diminished breath sounds

A nurse is reinforcing discharge teaching to a client who has COPD and a new prescription for albuterol, which indicates an understanding of the teaching??

I can have an increase in my heart rate while taking this medication

A nurse is reinforcing teaching for a client on the purpose of taking a bronchodilator. Which of the following client statements indicates understanding?

I take this medication to prevent asthma attacks.

The nurse is teaching a patient about an antihistamine recently prescribed. Which statement by the patient indicates that further teaching is needed?

I will be able to drive without any problem because I will know when I am impaired

A nurse is reinforcing teaching to a client on how to use of an incentive spirometer. Which of the following statements by the client indicates an understanding of the teaching?

I will take in a deep breath and hold it before exhaling

A nurse is reinforcing discharge teaching with a client who has a new prescription for prednisone for asthma. Which of the following client statements indicates understanding?

I will take my medication with meals

What antibody level must be evaluated before beginning omalizumab (Xolair)?

IgE

A nurse is reinforcing discharge instructions with a client who has COPD and experienced a pneumothorax. Which of the following statements should the nurse include?

Notify your provider if you experience a productive cough

Which beta-adrenergic agonist is used for the treatment of emphysema?

Olodaterol (Striverdi Respimat)

After explaining allergic rhinitis to the patient, the nurse realized further teaching was needed when the patient made which statement?

So this antihistamine will stop my running nose and itchy eyes as well as my nasal congestion

When evaluating the effectiveness of cromolyn sodium (Intal) therapy, what must the nurse consider?

The desired outcome of therapy is decreased frequency of allergic rhinitis and asthma attacks.

A nurse is assisting with the discharge of a client who has COPD. The client is concerned about not being able to leave the house die to the need for staying on continuous oxygen. Which of the following responses should the nurse make?

There are portable oxygen delivery systems that you can take with you

The nurse administered levocetirizine (Xyzal) to a patient who asks what the drug is for. The nurse makes which appropriate response?

This drug is for your seasonal allergy to ragweed and is an antihistamine

The nurse instructing the patient on the drug tiotropium bromide (spiriva) which was being started instead of continuing ipratropium bromide (Atrovent) realized further teaching was needed after the patient made which statement?

This drug is used to treat an acute attack like a rescue drug

The nurse is preparing the antitussive agent benzonatate (Tessalon perles) for a patient with a dry cough and knows the action of this drug will have which affect?

it will suppress the cough reflex response in the brain

A nurse is assisting the provider with care for a client who has developed a spontaneous pneumothorax. Which of the following actions should the nurse perform first?

obtain a large bore IV needle for decompression

A nurse is caring for a client who has a new diagnosis of TB and has been placed on a multimedication regimen. Which of the following instructions should the nurse give the client related to ethambutol?

watch for any changes in vision

A patient asks the nurse about the frequent upper respiratory illnesses that he has been experiencing. The nurse responds with which appropriate statement?

when you have an infection, the normal functioning of your upper respiratory system can be impaired. Avoid irritants such as smoke, chemicals, or allergens that might make your nasal passages more susceptible to infections

A nurse is preparing to administer a new prescription for isoniazid to a light skinned client who has TB. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication?

you might notice tingling of your hands

A nurse is reinforcing teaching to a client who has TB. Which of the following statements should the nurse include?

you will need to provide sputum samples every 4 weeks to monitor the effectiveness of the medication