Pharmacology II Prep U Chapter 55: Drugs Acting on the 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."

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."

When evaluating an asthmatic client's knowledge of self-care, the nurse recognizes that additional instructions are needed when the client makes which of the following statements?

"When I am short of breath, I will increase the use of my fluticasone."

A patient is receiving aminophylline orally. The nurse would expect this drug to begin acting within which time frame?

1 to 6 hours

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

15 mcg/mL

A client is using an inhaled bronchodilator as treatment for exercise-induced asthma. The nurse would instruct the client to use the inhaler at which time?

15 minutes before engaging in exercise

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 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

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

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?

Albuterol first, wait five minutes and then follow with flunisolide

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

When describing the events of an asthma attack to a client, the nurse incorporates understanding that stimulation of alpha-adrenergic receptors results in which of the following?

Bronchoconstriction

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 first step in treating obstructive pulmonary disorders involves medication therapy.

False

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?

Fluticasone

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

Increased serum theophylline

A nurse is administering levalbuterol to a client. The nurse would administer this drug by which route?

Inhalation

How do inhaled corticosteroid agents assist in the treatment of asthma?

Inhaled corticosteroid agents will reduce airway inflammation.

While reviewing a client's history, an allergy to which of the following would alert the nurse to a possible problem with the use of ipratropium?

Peanuts

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?

Rinse mouth with water after each use.

A man who smokes one pack of cigarettes daily has been diagnosed with chronic bronchitis. He has been prescribed theophylline by his family provider. What effect will the client's smoking status have on the therapeutic use of theophylline?

The client may require higher doses of theophylline than a nonsmoker

A therapeutic theophylline level ranges from 10 to 20 mcg/mL.

True

Cromolyn should not be used during an acute asthmatic attack.

True

A client is admitted to the emergency department with inspiratory stridor and air hunger. When anticipating treatment, the nurse will prepare which medication for administration?

epinephrine

What medical condition is likely to be exacerbated by the medication therapy associated with asthma?

gastroesophageal reflux disease (GERD)

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

rebound bronchoconstriction.

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

using a spacer

A 5-year-old boy is brought to the ED with an asthma exacerbation, including wheezing (a high-pitched, whistling sound caused by turbulent airflow through an obstructed airway). Those who have asthma chronically present with what signs, even when they may appear symptom free? (Select all that apply.)

• Airway inflammation • Damaged airway mucosa

When teaching a patient to use a dry powder inhaler, which of the following is true? Select all that apply:

• Hold breath for 10 seconds. • Inhale quickly.