CHAPTER 55 (DRUGS ACTING IN LOWER RESPIRATORY TRACT)

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?

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

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

15 mcg/mL

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 client is prescribed a leukotriene receptor antagonist. The nurse should evaluate the effectiveness of the medication therapy based on the long term management of symptoms associated with which respiratory condition?

Asthma

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

Beractant

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

Chocolate

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

Cigarette smoking

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?

Coffee

The nursing instructor is teaching a session explaining mast cell stabilizers. The instructor determines the session is successful when the students correctly choose which drug as an example?

Cromolyn

An 8-year-old client reports shortness of breath, cough, and chest tightness when participating in gym class. The client is diagnosed with exercise-induced asthma. What inhaled drug therapy is the health care provider most likely to prescribe?

Formoterol, a highly selective beta-2 agonist

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 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?

Ineffective breathing pattern

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?

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

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

Inhalation

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?

Inhaled corticosteroid agents reduce airway inflammation.

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?

Monitoring respirations for bilateral chest movement

The nurse is evaluating the education of a client that uses albuterol for an acute asthma attack. The nurse knows that the lesson has been effective when the client states that albuterol is which of the following types of medication?

SABA

The client is 73 years of age and has a history of coronary artery disease and COPD. She is being started on formoterol (Foradil). The nurse would assess the client for which of the following conditions? Select all that apply.

Tachycardia Hypertension

Why are inhaled steroids used to treat asthma and COPD?

They act locally to decrease release of inflammatory mediators

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?

Using a spacer

Which medication is contraindicated for the treatment of acute bronchospasm?

cromolyn

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

has a high coffee intake.

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

15 minutes prior to exercising

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

30 minutes before engaging in exercise

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?

9:30 AM

Tom, age 42, is prescribed ipratropium bromide as an anticholinergic agent for treating asthma. The nurse caring for Tom needs to develop a plan of care. What must be included in the plan? Select all that apply.

Advise the patient to avoid using ipratropium if allergic to soybeans, legumes, or soya lecithin. Remind the patient that ipratropium must be taken daily, despite the absence of symptoms of asthma.

Isoproterenol is an anticholinergic agent.

FALSE

An older adult client has been prescribed ipratropium by metered-dose inhaler and the nurse has provided education on using the device. When demonstrating the technique back to the nurse, the client is unable to coordinate pressing down on the inhaler and maintaining a seal with their lips. What is the nurse's best action?

Obtain a spacer and educate the client on its use.

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

Relaxation of smooth muscle

A nurse is preparing to teach a client the correct method to take cromolyn orally. Which instruction will the nurse point out as being the appropriate method to follow?

Take the drug at least 30 minutes before meals.

The nurse is preparing to teach a young client and caregiver about the prescribed cromolyn. The nurse should point out this can be administered in which manner(s)? Select all that apply.

Via a nebulizer Orally Nasal spray Metered-dose inhaler