PrepU Chapter 55
A patient is receiving aminophylline orally. The nurse would expect this drug to begin acting within which time frame? 2 to 4 hours 8 to 10 hours 6 to 8 hours 1 to 6 hours
1 to 6 hours Aminophylline has an onset of action of 1 to 6 hours.
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 A selective, short-acting, inhaled beta2-adrenergic agonist (e.g., albuterol) is the initial rescue drug of choice for acute bronchospasm; subcutaneous epinephrine may also be considered.
The nurse should be aware that concomitant use of what drug is contraindicated during tiotropium therapy? budesonide ipratropium theophylline fluticasone
ipratropium A client who is taking ipratropium should not take tiotropium because both drugs are anticholinergics. Theophylline and corticosteroids like budesonide and fluticasone are not necessarily contraindicated.
A client prescribed albuterol should be educated on identifying and managing which adverse reaction?
tachycardia The symptoms of cardiac stimulation, including tachycardia, are noted with the administration of albuterol. The client will not experience polydipsia, hypotension, or diarrhea because of the effects of albuterol.
The client has been prescribed cromolyn (Intal) for the treatment of asthma, and the nurse is evaluating the client's understanding of the medication. Which statement by the client indicates the need for further education? "I may experience wheezing with this medication." "I will use this medication when I am having an asthma attack." "This medication may also be used for allergy disorders." "This medication may cause my throat to become dry."
"I will use this medication when I am having an asthma attack." Cromolyn (Intal) is a mast cell stabilizer used in combination with other drugs in the treatment of asthma and other allergic disorders. Adverse reactions include drying of the throat and coughing or wheezing. It should not be used during an acute asthma attack because it may worsen the bronchospasm.
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 Albuterol is the initial drug of choice for acute bronchospasm.
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 Montelukast Zileuton Zafirkulast
Fluticasone Fluticasone is an inhaled steroid. Montelukast is a leukotriene receptor antagonist. Zileuton is a leukotriene receptor antagonist. Zafirkulast is a leukotriene receptor antagonist.
Where should the nurse initially direct a client who is interested in learning more about the management of asthma? Journal of Allergy and Clinical Immunology Centers for Disease Control Education Center Global Initiative for Asthma (GINA) National Association of Educational Pulmonologists
Global Initiative for Asthma (GINA) Management of asthma involves prevention of airway inflammation and avoidance of triggers for better symptom control. Because of asthma's significance as a world health problem, the Global Initiative for Asthma (GINA) published asthma guidelines of diagnosis, management, and education. These guidelines emphasize the importance of classifying asthma severity and the assessment of asthma control. While the other options may provide information on asthma, the GINA is most inclusive.
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 use of ipratropium is contraindicated in the presence of known allergy to the drug or to peanuts or soy products because the vehicle used to make ipratropium, an aerosol, contains a protein associated with peanut allergies.
A history of an allergy to which would be a contraindication to the use of anticholinergics? (Select all that apply.)
Soy Peanuts The use of ipratropium and tiotropium, anticholinergics, is contraindicated in the presence of known allergy to soy products or peanuts.
Which teaching intervention is a priority for the client prescribed an albuterol inhaler experiencing shortness of breath related to the physiological constriction of airways? Administer insulin to decrease hand shaking. Administer ibuprofen to decrease inflammation. Exercise should be limited to one time per week. Stop smoking due to the bronchoconstriction.
Stop smoking due to the bronchoconstriction. Cigarette smoking will increase bronchoconstriction, so the client should be encouraged to stop. The albuterol is known to cause hand tremors as a side effect. Insulin will not decrease hand shaking. The client will not require ibuprofen since the issue is not related to inflammation. The client should be encouraged to exercise, and it should not be limited to one time per week.
What pathology is present in a client diagnosed with chronic asthma even when they may appear symptom free? Select all that apply. elevated temperature bradycardia hypogastric secretions damaged airway mucosa airway inflammation
damaged airway mucosa airway inflammation Inflammation and damaged airway mucosa are chronically present in asthma, even when clients appear symptom free. None of the other options are associated with chronic asthma.
A client has been prescribed theophylline intravenously and began the therapy three days ago. The nurse suspects that the serum drug level is above therapeutic levels when the client makes what statement? Select all that apply. "It feels like my heart is beating faster than usual." "I need to tell you that I vomited a few minutes ago." "I'm so tired; I haven't been sleeping well." "I don't want lunch; I'm feeling nauseous." "Please look at this rash I have on my chest and neck."
"I don't want lunch; I'm feeling nauseous." "I'm so tired; I haven't been sleeping well." "It feels like my heart is beating faster than usual." "I need to tell you that I vomited a few minutes ago." Signs and symptoms of theophylline overdose include anorexia, nausea, vomiting, agitation, nervousness, insomnia, tachycardia and other dysrhythmias, and tonic-clonic convulsions. A rash is not associated with toxic levels of theophylline.
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." Just before each use, the client should shake the inhaler well. After shaking, proper technique involves exhaling before placing the inhaler in the mouth; taking a slow, deep breath while delivering the medication into the mouth; and holding the breath for approximately ten seconds before exhaling slowly. A subsequent dose can be administered within a few minutes of the first.
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? "This medication is safe for kids like me." "We need to let the health care provider know if the medicine gives me a headache or makes me dizzy." "This is a new kind of asthma medication." "I need to take the medication when I start to have problems breathing."
"I need to take the medication when I start to have problems breathing." These drugs are not indicated for the treatment of acute asthmatic attacks because they do not provide any immediate effects on the airways. Patients need to be cautioned that they should not rely on these drugs for relief from an acute asthmatic attack. The remaining statements are all accurate information regarding this classification of medications.
A client recently diagnosed with asthma anxiously reports that the symptoms of a recent episode were not relieved despite taking several puffs of the prescribed salmeterol. How should the nurse respond to the client's concern? "It's important to take salmeterol as soon as you feel the first sensation of an asthma attack." "Remember that your salmeterol isn't effective when you take it at the time of an asthma attack." "Unfortunately, Sereventsalmeterol can take up to 15 minutes to relieve your difficulty breathing." "It's best to take repeated doses of salmeterol every 5 minutes, until your symptoms subside."
"Remember that your salmeterol isn't effective when you take it at the time of an asthma attack." Salmeterol is a long-acting beta2-adrenergic agonist used only for prophylaxis of acute bronchoconstriction. Salmeterol is not effective in acute attacks because it has a slower onset of action than a short-acting drug. This information makes all the other options incorrect.
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? "I will wash my sheets weekly." "When I am short of breath, I will increase the use of my fluticasone." "When I can do some, but not all of my usual activities, I am in the yellow zone." "I need to inhale my medication and hold my breath for 10 seconds."
"When I am short of breath, I will increase the use of my fluticasone." Fluticasone is an inhaled steroid and should not be used during acute asthmatic attacks. Washing linens weekly will decrease the incidence of dust mites. When clients can participate in some, but not all of usual activities, they are in the yellow zone. Once medication is inhaled, the client should hold his or her breath for 10 seconds so that medication can reach deep into the lungs.
A patient is receiving aminophylline orally. The nurse would expect this drug to begin acting within which time frame? 6 to 8 hours 2 to 4 hours 1 to 6 hours 8 to 10 hours
1 to 6 hours Aminophylline has an onset of action of 1 to 6 hours.
A client is receiving ipratropium as maintenance therapy for chronic obstructive pulmonary disease. The nurse would caution the client that up to how many inhalations may be used in 24 hours if needed? 12 8 16 4
12 With ipratropium, the usual dosage is 2 inhalations four times/day for a total of 8 inhalations. However, the client can use up to 12 inhalations if needed in 1 day.
The nurse assesses the serum theophylline of a client. Which finding would the nurse identify as being therapeutic?
15 mcg/mL Therapeutic theophylline levels range from 10 to 20 mcg/mL. A value of 15 mcg/mL would be considered therapeutic.
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)?
Albuterol Albuterol is a SABA. Formoterol, salmeterol, and arformoterol are all long-acting beta-2 agonists.
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? Pneumonia Asthma Chronic bronchitis Emphysema
Asthma Leukotriene receptor antagonists block or antagonize receptors for the production of leukotrienes D4 and E4, thus blocking many of the signs and symptoms of asthma. This class of medication is not typically associated with the long term management of any of the other options.
A client is experiencing an acute asthmatic attack. Which agent would be most effective? Leukotriene receptor antagonist Mast cell stabilizer Beta-2 selective adrenergic agonist Inhaled steroid
Beta-2 selective adrenergic agonist A beta-2 selective adrenergic agonist or sympathomimetic would be most appropriate because these agents are rapidly distributed after injection and rapidly absorbed after inhalation. An inhaled steroid would require 2 to 3 weeks to reach effective levels. Leukotriene receptor antagonists and mast cell stabilizers do not have immediate effects.
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? Vitamin C Coffee Alcohol Salt
Coffee The nurse should assess the patient's intake of caffeine, including coffee, tea, soda, cocoa, candy, and chocolate. Caffeine has sympathomimetic effects that may increase the risk for adverse effects. Alcohol, salt, and vitamin C intake is important to assess, but does not potentiate the effects of albuterol.
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 nurse should assess the patient's intake of caffeine, including coffee, tea, soda, cocoa, candy, and chocolate. Caffeine has sympathomimetic effects that may increase the risk for adverse effects. Alcohol, salt, and vitamin C intake is important to assess, but does not potentiate the effects of albuterol.
The client's theophylline levels are increased when the lab results are added to the electronic health record. The nurse questions the client about his intake of which?
Coffee Xanthines are found in colas, coffee, chocolate, and charcoal-prepared foods. This could cause the client's theophylline levels to increase. Neither tea, carrots, nor cheese affect theophylline levels.
A client is prescribed salmeterol. The nurse would expect this drug to be administered by which route?
Inhalation Salmeterol is administered via inhalation.
A neonate is receiving beractant. The nurse understands that this agent is administered by which route? Intratracheal Subcutaneous Intramuscular Intravenous
Intratracheal Beractant is administered intratracheally.
A neonate is receiving beractant. The nurse understands that this agent is administered by which route? Intravenous Subcutaneous Intramuscular Intratracheal
Intratracheal Beractant is administered intratracheally.
Which agents would the nurse identify as selectively and competitively blocking the receptors for the production of two substances that are components of SRSA? Leukotriene receptor antagonists Xanthines Mast cell stabilizers Anticholinergics
Leukotriene receptor antagonists Leukotriene receptor antagonists selectively and competitively block or antagonize receptors for the production of leukotrienes D4 and E4, components of SRSA. Xanthines are thought to work by directly affecting the mobilization of calcium within the cell by stimulating two prostaglandins, resulting in smooth muscle relaxation. Xanthines also inhibit the release of slow-reacting substance of anaphylaxis (SRSA) and histamine. Mast cell stabilizers work at the cellular level to inhibit the release of histamine (released from mast cells in response to inflammation or irritation) and inhibits the release of SRSA. Anticholinergics are used as bronchodilators because of their effect on the vagus nerve, which is to block or antagonize the action of the neurotransmitter acetylcholine at vagal-mediated receptor sites.
Which medication is used to treat acute airflow obstruction? Metaproterenol Azelastine Montelukast Beclomethasone
Metaproterenol Metaproterenol is a short-acting beta-2 agonist used as a quick-relief medication. Beclomethasone is an inhaled corticosteroid used as a long-term control medication. Montelukast is a leukotriene antagonist used for prophylactic treatment of chronic asthma. Azelastine is a second-generation antihistamine.
A client with COPD takes theophylline. The nurse identifies that the client is still experiencing severe dyspnea. Upon review of labs, the theophylline level remains nontherapeutic. The nurse evaluates the client for which of the following drugs that may cause decreased theophylline levels? Nicotine Corticosteroids Allopurinol Cimetidine
Nicotine
A client with COPD takes theophylline. The nurse identifies that the client is still experiencing severe dyspnea. Upon review of labs, the theophylline level remains nontherapeutic. The nurse evaluates the client for which of the following drugs that may cause decreased theophylline levels?
Nicotine When combined with nicotine, theophylline levels are decreased. Allopurinol, cimetidine, and corticosteroids can increase theophylline levels.
A female client presents to the emergency department with acutely deteriorating asthma. Her husband tells the nurse that his wife takes salmeterol. He then tells the nurse that he gave her three extra puffs when she became ill. What statement is correct in this situation? The extra doses facilitated bronchodilation and probably saved her life. The husband made the correct decision in giving the extra doses. Salmeterol is contraindicated based on his wife's condition. The health care provider will most likely order continuation of the salmeterol with increased dosage.
Salmeterol is contraindicated based on his wife's condition. The FDA has issued a black box warning that initiating salmeterol in people with significantly worsening or acutely deteriorating asthma may be life threatening.
After teaching a group of students about inhaled steroids, the instructor determines that the teaching was successful when the students state: The drugs action leads to suppression of beta adrenergic receptor activity. The drugs are slowly absorbed from the respiratory tract. The drugs are systemically absorbed when inhaled. The drugs are not for use during an acute attack.
The drugs are not for use during an acute attack. The drugs are not for emergency use or use during an acute attack because their onset of action is slow. Systemic absorption is not typical with inhalation unless the patient did not administer the drug properly or has lesions that allowed absorption of the drug. Inhalation decreases the effectiveness of the inflammatory cells leading to decreased swelling and promotion of beta adrenergic receptor activity. The drugs are rapidly absorbed, but take 2 to 3 weeks to reach effective levels.
A child prescribed an inhaled corticosteroid agent to decrease respiratory inflammation is now receiving high doses of the drug after only 2 days of treatment. What adverse reaction is the client at risk for developing? adrenal insufficiency edema hypoglycemia tachycardia
adrenal insufficiency Adrenal insufficiency is most likely to occur with systemic or high doses of inhaled corticosteroids. The client is not at risk for tachycardia, edema, or hypoglycemia unless related to adrenal insufficiency.
What is the most common first-line therapy for relief of an acute asthma attack? inhaled steroid beta2-adrenergic agonist leukotriene modifier xanthine
beta2-adrenergic agonist A client experiencing an acute asthma attack should be administered a beta2-adrenergic agonist. The client can receive an inhaled steroid, but it is not the first-line therapy. Leukotriene modifiers are used for maintenance in asthma, not during acute exacerbation. Xanthines are not the drug of choice in acute asthma attack.
What is the most common first-line therapy for relief of an acute asthma attack? inhaled steroid leukotriene modifier beta2-adrenergic agonist xanthine
beta2-adrenergic agonist A client experiencing an acute asthma attack should be administered a beta2-adrenergic agonist. The client can receive an inhaled steroid, but it is not the first-line therapy. Leukotriene modifiers are used for maintenance in asthma, not during acute exacerbation. Xanthines are not the drug of choice in acute asthma attack.
An adult client with a diagnosis of asthma has been prescribed montelukast. The nurse should teach the client that this drug will help relieve symptoms by which mechanism? preventing the bronchoconstriction and inflammation that is caused by leukotrienes relaxing smooth muscle in the bronchi and bronchioles preventing mast cells from releasing histamine reducing the muscle tone in the alveoli and facilitating gas exchange
preventing the bronchoconstriction and inflammation that is caused by leukotrienes Montelukast prevents leukotrienes from binding to its receptors reducing the bronchoconstriction and ultimate inflammation caused by leukotrienes. This information makes all the remaining options incorrect.
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. The main result of albuterol binding to beta-2 receptors in the lungs is relaxation of bronchial smooth muscles. This relaxation of bronchial smooth muscle relieves bronchospasm, reduces airway resistance, facilitates mucous drainage, and increases vital capacity.
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 Albuterol is a bronchodilator and should be used first, given time to open the airways, and then the inhaled corticosteroid is administered.
A client is given theophylline to treat acute asthma symptoms. Which food should the client avoid?
Chocolate Chocolate contains caffeine and is also a xanthine; thus chocolate should be avoided when the client is taking theophylline. Restriction of bananas, orange juice, and cranberry juice is not required.
A client was using a nicotine patch to stop smoking when he was started on theophylline for emphysema. He has successfully stopped smoking and has stopped using his nicotine patch. Which of following would the nurse anticipate about the prescribed theophylline?
Dose should be decreased. Nicotine decreases theophylline levels. If a client is no longer using nicotine, his theophylline levels will increase, warranting a decrease in theophylline dose. The drug should not be discontinued as the client may develop exacerbation of the emphysema. The dose should not be increased because the nicotine patch decreases the theophylline levels. Adjustment should be made to keep the client's theophylline levels in the desired range.
Which of the following would be most important to assess before administering calfactant? (Select all that apply.)
Endotracheal tube placement Lung sounds Oxygen saturation levels Before administering calfactant, it would be important to ensure proper endotracheal tube placement because the drug is instilled directly into the trachea. In addition, lung sounds and oxygen saturation levels would be important as a baseline to evaluate effectiveness of the drug.
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 Zafirkulast Montelukast Zileuton
Fluticasone Fluticasone is an inhaled steroid. Montelukast is a leukotriene receptor antagonist. Zileuton is a leukotriene receptor antagonist. Zafirkulast is a leukotriene receptor antagonist.
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 airway clearance Impaired gas exchange Ineffective breathing pattern Activity intolerance
Ineffective breathing pattern The correct nursing diagnosis is Ineffective Breathing Pattern related to impaired airway as manifested by tachypnea. The other options may be applicable, but they do not take priority over the ineffective breathing pattern.
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? Bradycardia Hypotension Nervousness Fatigue
Nervousness Frequent use of sympathomimetic inhalers can cause nervousness, hypertension, tachycardia, and anxiety.
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? Antiasthma LABA Leukotriene modifier SABA
SABA Albuterol is a short-acting beta-2 agonist (SABA). It is used to treat and prevent bronchospasm.
A female client presents to the emergency department with acutely deteriorating asthma. Her husband tells the nurse that his wife takes salmeterol. He then tells the nurse that he gave her three extra puffs when she became ill. What statement is correct in this situation?
Salmeterol is contraindicated based on his wife's condition. The FDA has issued a black box warning that initiating salmeterol in people with significantly worsening or acutely deteriorating asthma may be life threatening.
What medical condition is likely to be exacerbated by the medication therapy associated with asthma? cataracts urinary retention gastroesophageal reflux disease (GERD) dermatitis
gastroesophageal reflux disease (GERD) Asthma, may aggravate GERD, because antiasthma medications that dilate the airways also relax muscle tone in the gastroesophageal sphincter and may increase acid reflux. The relationship between asthma medications and the other options is not supported by research data.
An adult client with a diagnosis of asthma has been prescribed montelukast. The nurse should teach the client that this drug will help relieve symptoms by which mechanism? relaxing smooth muscle in the bronchi and bronchioles preventing the bronchoconstriction and inflammation that is caused by leukotrienes preventing mast cells from releasing histamine reducing the muscle tone in the alveoli and facilitating gas exchange
preventing the bronchoconstriction and inflammation that is caused by leukotrienes Montelukast prevents leukotrienes from binding to its receptors reducing the bronchoconstriction and ultimate inflammation caused by leukotrienes. This information makes all the remaining options incorrect.
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? Immediately after beginning to exercise 15 minutes before engaging in exercise Midway during the exercise routine Right before and after exercising
15 minutes before engaging in exercise The client should use the inhaler approximately 15 minutes before exercising to achieve the maximum therapeutic effects.
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 client should use the inhaler approximately 15 minutes before exercising to achieve the maximum therapeutic effects.
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 Inhaled ipratropium has an onset of action of 15 minutes, so the patient should begin to feel the effects of the drug at 9:30 AM.
The parents of a 7-year-old client who has been diagnosed with allergic asthma are being taught about their son's medication regimen. The nurse is teaching about the appropriate use of a "rescue drug" for acute exacerbations. What drug should the nurse suggests the parents to use in these situations?
Albuterol Albuterol is a rescue drug that should be used first for all acute symptoms of shortness of breath or wheezing. Theophylline does not produce rapid symptom relief and beclomethasone is a maintenance drug. Acetylcysteine is not used in the treatment of asthma because it is used to manage secretions, which are not associated with asthma.
Which of the following would a nurse identify as a surfactant?
Beractant Beractant is a lung surfactant. Cromolyn is a mast cell stabilizer. Zileuton is a leukotriene receptor antagonist. Theophylline is a xanthine.
A client is experiencing an acute asthmatic attack. Which agent would be most effective? Inhaled steroid Mast cell stabilizer Beta-2 selective adrenergic agonist Leukotriene receptor antagonist
Beta-2 selective adrenergic agonist A beta-2 selective adrenergic agonist or sympathomimetic would be most appropriate because these agents are rapidly distributed after injection and rapidly absorbed after inhalation. An inhaled steroid would require 2 to 3 weeks to reach effective levels. Leukotriene receptor antagonists and mast cell stabilizers do not have immediate effects.
The nurse is developing an asthma plan for a young client and caregiver. The nurse determines they understand the plan when they correctly choose which actions to implement? Select all that apply.
Call health care provider is in yellow zone for more than 24 hours Quick-relief medications are not working The Asthma Care Plan utilizes the stop light approach with red, yellow, and green activities to guide the client in helping to maintain their control of asthma. Factors such as staying in the yellow zone for more than 24 hours and quick-relief medications not working are found in the red zone and necessitate an immediate call to the health care provider to advert a crisis. Waking up at night with wheezing, peak flow of 55% of personal best, and being able to only do some but not all usual activities are found in the yellow zone and should alert the client to take appropriate action to prevent the asthma from worsening..
The nurse should complete which of the following during acute breathing distress before initiation of a broncodilator? Select all that apply: Check blood pressure. Check peak flow Check pulse. Check blood glucose. Check respiratory rate
Check blood pressure. Check pulse. Check respiratory rate Prior to initiation of a bronchodilator during acute breathing distress, the nurse needs to take a blood pressure, pulse, and respiratory rate.
The nurse should complete which of the following during acute breathing distress before initiation of a broncodilator? Select all that apply: Check pulse. Check blood pressure. Check respiratory rate Check blood glucose. Check peak flow
Check blood pressure. Check pulse. Check respiratory rate Prior to initiation of a bronchodilator during acute breathing distress, the nurse needs to take a blood pressure, pulse, and respiratory rate.
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? Calfactant Cromolyn Triamcinolone Montelukast
Cromolyn Cromolyn is a mast cell stabilizer. Montelukast is a leukotriene receptor antagonist. Calfactant is a lung surfactant. Triamcinolone is an inhaled steroid.
Which of the following would be most important to assess before administering calfactant? (Select all that apply.) Bowel sounds Oxygen saturation levels Lung sounds Endotracheal tube placement Abdominal girth
Endotracheal tube placement Lung sounds Oxygen saturation levels Before administering calfactant, it would be important to ensure proper endotracheal tube placement because the drug is instilled directly into the trachea. In addition, lung sounds and oxygen saturation levels would be important as a baseline to evaluate effectiveness of the drug.
A 27-year-old athlete with newly diagnosed asthma presents for patient education regarding situations that could precipitate an asthma attack. The nurse teaches that acute episodes of asthma may last minutes to hours. In this teaching, which precipitants would the nurse state may cause the asthma? (Select all that apply.) Warm weather Exercise Pollutants Allergens
Exercise Allergens Pollutants Precipitants may include allergens (e.g., pollens, molds), airway irritants and pollutants (e.g., chemical fumes, cigarette smoke, automobile exhaust), cold air, and exercise.
When teaching a patient to use a dry powder inhaler, which of the following is true? Select all that apply: Hold inhaler 1 to 2 inches from mouth. Place device in water to clean. Inhale quickly. Swallow capsules provided. Hold breath for 10 seconds.
Hold breath for 10 seconds. Inhale quickly. To properly use a dry powder inhaler prepare the medication for inhalation, place mouthpiece to lips, inhale quickly, hold your breath for 10 seconds, do not swallow capsules provided, and do not place inhaler in water.
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? Changing the newborn's position frequently to assure effective distribution of medication Suctioning the infant every 30 minutes for 2 hours after the treatment has been initiated Monitoring respirations for bilateral chest movement Supply supplemental oxygen as prescribed
Monitoring respirations for bilateral chest movement Ensure proper placement of the endotracheal tube with bilateral chest movement and lung sounds to provide adequate delivery of the drug. Suctioning should be avoided for at least 2 hours after the surfactin is instilled into the newborn's endotracheal tube. Neither the delivery of supplemental oxygen nor position changes are related to the delivery of the medication into the infant's lungs.
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?
Nervousness Frequent use of sympathomimetic inhalers can cause nervousness, hypertension, tachycardia, and anxiety.
A client, experiencing respiratory distress related bronchi constriction, will benefit from what therapeutic action provided by anticholinergic medication therapy? Relaxation of smooth muscle Enhancement of alveolar expansion Decrease in the production of leukotrienes D4 and E4 Reduction of the inflammatory response
Relaxation of smooth muscle Anticholinergics can be used as bronchodilators because of their effect on the vagus nerve, resulting in relaxation of smooth muscle in the bronchi, which leads to bronchodilation. None of the other options describe the bronchial dilation affected of the anticholinergic classification of medications.
A premature newborn diagnosed with respiratory distress syndrome(RDS) has received surfactant therapy. The infant's nursing care plan should include which monitoring interventions to evaluate the effectiveness of the therapy? Select all that apply. Respirations Adventitious breath sounds Heart rate Endotracheal tube placement Chest movement
Respirations Adventitious breath sounds Endotracheal tube placement Chest movement Monitor respirations, adventitious sounds, endotracheal tube placement and patency, and chest movements to evaluate the effectiveness of the drug and drug delivery. Heart rate is monitored to determine the infant's general health status.
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? Antiasthma Leukotriene modifier LABA SABA
SABA Albuterol is a short-acting beta-2 agonist (SABA). It is used to treat and prevent bronchospasm.
The nurse is describing how aminophylline achieves its effect. Which would the nurse incorporate into the description?
Stimulation of the central nervous system Stimulation of the central nervous system is the mechanism of action for xanthine derivatives. Stimulation of beta-adrenergic receptors is the mechanism of action for beta-2 agonists. Reduction of airway hyperresponsiveness is the mechanism of action for inhaled corticosteroids. Stabilization of mast cell membranes is the mechanism of action for mast cell stabilizers.
After teaching a group of students about inhaled steroids, the instructor determines that the teaching was successful when the students state: The drugs are slowly absorbed from the respiratory tract. The drugs are systemically absorbed when inhaled. The drugs are not for use during an acute attack. The drugs action leads to suppression of beta adrenergic receptor activity.
The drugs are not for use during an acute attack. The drugs are not for emergency use or use during an acute attack because their onset of action is slow. Systemic absorption is not typical with inhalation unless the patient did not administer the drug properly or has lesions that allowed absorption of the drug. Inhalation decreases the effectiveness of the inflammatory cells leading to decreased swelling and promotion of beta adrenergic receptor activity. The drugs are rapidly absorbed, but take 2 to 3 weeks to reach effective levels.
What is the most common first-line therapy for relief of an acute asthma attack? leukotriene modifier xanthine inhaled steroid beta2-adrenergic agonist
beta2-adrenergic agonist A client experiencing an acute asthma attack should be administered a beta2-adrenergic agonist. The client can receive an inhaled steroid, but it is not the first-line therapy. Leukotriene modifiers are used for maintenance in asthma, not during acute exacerbation. Xanthines are not the drug of choice in acute asthma attack.
What is considered a possible trigger for an asthma attack? Select all that apply.
exercise allergens pollutants cigarette smoke Precipitants may include allergens (e.g., pollens, molds), airway irritants and pollutants (e.g., chemical fumes, cigarette smoke, automobile exhaust), cold air, and 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? 9:45 AM 9:30 AM 10:00 AM 10:15 AM
9:30 AM Inhaled ipratropium has an onset of action of 15 minutes, so the patient should begin to feel the effects of the drug at 9:30 AM.
Which statement by a client who is prescribed triamcinolone indicates the need for additional teaching? "I can't use this drug if I have an acute attack." "I should rinse my mouth after using the drug." "I might notice some hoarseness with the drug." "I should see some results in about 3 to 4 days."
"I should see some results in about 3 to 4 days." Inhaled steroids, such as triamcinolone, can take from 2 to 3 weeks to reach effective levels, so the client should be encouraged to take them to reach and then maintain the effective levels. The drug is not effective for acute attacks. It can cause hoarseness and sore throat. The client should rinse his mouth after using the inhaler to decrease the risk of systemic absorption and decrease gastrointestinal upset and nausea.
Which statement by a client who is prescribed triamcinolone indicates the need for additional teaching? "I might notice some hoarseness with the drug." "I should see some results in about 3 to 4 days." "I should rinse my mouth after using the drug." "I can't use this drug if I have an acute attack."
"I should see some results in about 3 to 4 days." Inhaled steroids, such as triamcinolone, can take from 2 to 3 weeks to reach effective levels, so the client should be encouraged to take them to reach and then maintain the effective levels. The drug is not effective for acute attacks. It can cause hoarseness and sore throat. The client should rinse his mouth after using the inhaler to decrease the risk of systemic absorption and decrease gastrointestinal upset and nausea.
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?
A 65-year-old male with asthma The nurse can safely administer theophylline to the client who is 65 years of age. It needs to be administered cautiously in clients older 69 years of age or those with hepatic disease, cardiac disease, or hypertension.
A male client presents to the emergency department in bronchospasm. He has a history of smoking two packs per day for 20 years and is prescribed phenytoin to control a seizure disorder that developed after a head injury 3 years ago. Based on the client's history, what would the nurse expect the health care provider to order?
A modified dose of aminophylline Cigarette smoking and drugs that stimulate drug-metabolizing enzymes in the liver (e.g., phenobarbital, phenytoin) increase the rate of metabolism and, therefore, the dosage requirements of aminophylline.
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 Bradycardia Elevated temperature
Airway inflammation Damaged airway mucosa Inflammation and damaged airway mucosa are chronically present in asthma, even when clients appear symptom free.
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 Leukotriene receptor antagonists block or antagonize receptors for the production of leukotrienes D4 and E4, thus blocking many of the signs and symptoms of asthma. This class of medication is not typically associated with the long term management of any of the other options.
A client is given theophylline to treat acute asthma symptoms. Which food should the client avoid? Bananas Orange juice Chocolate Cranberry juice
Chocolate Chocolate contains caffeine and is also a xanthine; thus chocolate should be avoided when the client is taking theophylline. Restriction of bananas, orange juice, and cranberry juice is not required.
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?
Contact the care provider and inform him or her that the client has toxic theophylline levels. To determine theophylline dosage, prescribers should measure serum theophylline levels. Therapeutic range is 5 to 15 mcg/mL (27.75 to 83.25 µmol/L); toxic levels are 20 mcg/mL (111 µmol/L) or above. The care provider must be informed of this elevated serum level.
A client was using a nicotine patch to stop smoking when he was started on theophylline for emphysema. He has successfully stopped smoking and has stopped using his nicotine patch. Which of following would the nurse anticipate about the prescribed theophylline? Dose should be increased. Dose should be decreased. The drug should be discontinued. The client will receive the same amount.
Dose should be decreased. Nicotine decreases theophylline levels. If a client is no longer using nicotine, his theophylline levels will increase, warranting a decrease in theophylline dose. The drug should not be discontinued as the client may develop exacerbation of the emphysema. The dose should not be increased because the nicotine patch decreases the theophylline levels. Adjustment should be made to keep the client's theophylline levels in the desired range.
A 27-year-old athlete with newly diagnosed asthma presents for patient education regarding situations that could precipitate an asthma attack. The nurse teaches that acute episodes of asthma may last minutes to hours. In this teaching, which precipitants would the nurse state may cause the asthma? (Select all that apply.) Warm weather Exercise Allergens Pollutants
Exercise Allergens Pollutants Precipitants may include allergens (e.g., pollens, molds), airway irritants and pollutants (e.g., chemical fumes, cigarette smoke, automobile exhaust), cold air, and exercise.
Isoproterenol is an anticholinergic agent. True False
False Isoproterenol is a sympathomimetic agent.
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? Theophylline, a xanthine derivative Formoterol (Foradil), a highly selective beta-2 agonist Epinephrine, a nonselective adrenergic agonist Terbutaline (Brethine), a beta-2 selective adrenergic agonist
Formoterol (Foradil), a highly selective beta-2 agonist Formoterol is used primarily to prevent exercise-induced asthma, although it may also be used in clients with emphysema or chronic bronchitis. Epinephrine induces multiple adverse reactions, while terbutaline's main pharmacotherapeutic effect is the prevention of bronchospasm, and it is also clinically used to abort premature labor. Theophylline is administered orally or intravenously.
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." Antiasthma medications should normally be taken on a regular schedule, not solely based on immediate symptoms. They should not be discontinued in the absence of symptoms. Increasing fluid intake, limiting caffeine, and adhering to the administration schedule are correct actions.
A client who smokes is receiving theophylline orally. Because of his history of smoking, the nurse expects the health care provider to do what with the theophylline dosing? Discontinue Decrease Increase Monitor closely
Increase Nicotine from smoking interferes with the ability of the body to metabolize theophylline. Due to decreased metabolism, the dosage of theophylline would be increased.
A client with asthma is administered zileuton along with theophylline. The nurse should be especially alert for which of the following? Increased serum theophylline Increased serum zileuton Increased prothrombin time Increased pulse rate
Increased serum theophylline When administering zileuton along with theophylline, the nurse should monitor for increased serum theophylline. Serum zileuton levels and pulse rate are not increased when zileuton is administered along with theophylline. Increased prothrombin time is seen when warfarin, and not theophylline, is given along with zileuton.
A client with asthma is administered zileuton along with theophylline. The nurse should be especially alert for which of the following? Increased serum zileuton Increased prothrombin time Increased pulse rate Increased serum theophylline
Increased serum theophylline When administering zileuton along with theophylline, the nurse should monitor for increased serum theophylline. Serum zileuton levels and pulse rate are not increased when zileuton is administered along with theophylline. Increased prothrombin time is seen when warfarin, and not theophylline, is given along with zileuton.
A client with asthma is administered zileuton along with theophylline. The nurse should be especially alert for which of the following?
Increased serum theophylline When administering zileuton along with theophylline, the nurse should monitor for increased serum theophylline. Serum zileuton levels and pulse rate are not increased when zileuton is administered along with theophylline. Increased prothrombin time is seen when warfarin, and not theophylline, is given along with zileuton.
How do inhaled corticosteroid agents assist in the treatment of asthma?
Inhaled corticosteroid agents will reduce airway inflammation. Inhaled corticosteroid agents suppress the release of inflammatory mediators, block the generations of cytokines, and decrease the recruitment of airway eosinophils. Inhaled corticosteroid agents do not depress the central nervous system or affect either bronchodilation or constriction.
Which agents would the nurse identify as selectively and competitively blocking the receptors for the production of two substances that are components of SRSA? Leukotriene receptor antagonists Anticholinergics Xanthines Mast cell stabilizers
Leukotriene receptor antagonists Leukotriene receptor antagonists selectively and competitively block or antagonize receptors for the production of leukotrienes D4 and E4, components of SRSA. Xanthines are thought to work by directly affecting the mobilization of calcium within the cell by stimulating two prostaglandins, resulting in smooth muscle relaxation. Xanthines also inhibit the release of slow-reacting substance of anaphylaxis (SRSA) and histamine. Mast cell stabilizers work at the cellular level to inhibit the release of histamine (released from mast cells in response to inflammation or irritation) and inhibits the release of SRSA. Anticholinergics are used as bronchodilators because of their effect on the vagus nerve, which is to block or antagonize the action of the neurotransmitter acetylcholine at vagal-mediated receptor sites.
The nurse is providing care for a newborn who has received an instillation of surfactin. What assessment data indicates the infant is experiencing adequate oxygen perfusion? Select all that apply. Chest moves bilaterally with respirations Skin warm to the touch Breath sounds normal Skin is pink over entire body Infant temperature within normal limits
Skin is pink over entire body Skin warm to the touch Assess the skin temperature and color to evaluate perfusion of a newborn receiving surfactant. Breath sounds and chest movement would be monitored to determine effective ventilation. Temperature would be monitored for possible infection.
What is considered a possible trigger for an asthma attack? Select all that apply. cigarette smoke pollutants warm weather allergens exercise
exercise allergens pollutants cigarette smoke Precipitants may include allergens (e.g., pollens, molds), airway irritants and pollutants (e.g., chemical fumes, cigarette smoke, automobile exhaust), cold air, and exercise.
What medical condition is likely to be exacerbated by the medication therapy associated with asthma?
gastroesophageal reflux disease (GERD) Asthma, may aggravate GERD, because antiasthma medications that dilate the airways also relax muscle tone in the gastroesophageal sphincter and may increase acid reflux. The relationship between asthma medications and the other options is not supported by research data.
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. Caffeine has sympathomimetic effects that may increase the risk for adverse effects with albuterol. The nurse should assess the patient's intake of caffeine through coffee, tea, soda, cocoa, candy, and chocolate. The patient's age, history of pneumonia, and preference for high-calorie food would not have important implications for his albuterol drug therapy.
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 permanent liver damage. community-acquired pneumonia. severe anticholinergic effects. rebound bronchoconstriction.
rebound bronchoconstriction. Patients who self-administer albuterol may use their MDIs more frequently than recommended. This practice can result in rebound bronchoconstriction, which may motivate the patient to increase MDI use, stimulating the cycle of rebound congestion. Overuse of albuterol is not linked to pneumonia or hepatotoxicity. Albuterol is not an anticholinergic drug.
Which statement made by a nurse providing care to a newborn prescribed surfactin therapy indicates a need for additional instructions to ensure the medication's effectiveness? "The baby requires suctioning every 1 hour for 4 hours after the instillation of surfactant." "The baby needs suctioning just prior to the instillation of the surfactin." "The baby should be suctioned after the instillation of the surfactant only if clinically necessary." "Suctioning should be avoided for at least 2 hours after the surfactant instillation."
"The baby requires suctioning every 1 hour for 4 hours after the instillation of surfactant." Suction the infant immediately before administration, but do not suction for 2 hours after administration unless clinically necessary, to allow the drug time to work.
A male client presents to the emergency department in bronchospasm. He has a history of smoking two packs per day for 20 years and is prescribed phenytoin to control a seizure disorder that developed after a head injury 3 years ago. Based on the client's history, what would the nurse expect the health care provider to order? A modified dose of aminophylline The standard dose of aminophylline A drug other than aminophylline Phenytoin intravenously
A modified dose of aminophylline Cigarette smoking and drugs that stimulate drug-metabolizing enzymes in the liver (e.g., phenobarbital, phenytoin) increase the rate of metabolism and, therefore, the dosage requirements of aminophylline.
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?
Cromolyn Cromolyn is a mast cell stabilizer. Montelukast is a leukotriene receptor antagonist. Calfactant is a lung surfactant. Triamcinolone is an inhaled steroid.
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? Nervousness Bradycardia Hypotension Fatigue
Nervousness Frequent use of sympathomimetic inhalers can cause nervousness, hypertension, tachycardia, and anxiety.
Mark, 8 years old, is prescribed flunisolide. The physician advises Mark and his parents to use a spacer when administering this medication. What is the benefit of such use? It reduces the risk of sinusitis. It helps decrease the intrapulmonary delivery of the drug. It reduces the risk of tachycardia. It helps decrease systemic absorption.
It helps decrease systemic absorption. Spacers help decrease systemic absorption, because less flunisolide is swallowed. Spacers may also help alleviate dysphonia by filtering larger aerosol particles that ordinarily deposit in the oropharynx and extrathoracic airways (this precaution also reduces the risk for oropharyngeal candidiasis). The use of a spacer does not prevent intrapulmonary delivery of the drug; nor does it reduce the risk of tachycardia and sinusitis.
When teaching a client about his prescribed asthma therapy, the nurse understands that which medications may increase the risk of asthma-related death? Inhaled corticosteroids (ICSs) Short-acting beta agonists (SABAs) Long-acting beta-2 agonists Mast cell stabilizers
Long-acting beta-2 agonists Long-acting beta-2 agonists may increase the risk of asthma-related death. ICSs are contraindicated in clients with hypersensitivity to the corticosteroids, acute bronchospasm, status asthmaticus, or other acute episodes of asthma and can cause throat irritation, hoarseness, upper respiratory tract infection, and fungal infections of the mouth and throat. SABA bronchodilators are drugs used to relieve bronchospasm associated with respiratory disorders, such as bronchial asthma, chronic bronchitis, and emphysema but can cause tachycardia, palpations, arrhythmias, hypertension, nervousness, anxiety, and insomnia. The mast cell stabilizer is contraindicated in clients with known hypersensitivity to the drugs and during attacks of acute asthma, because they may worsen bronchospasm during the acute asthma attack. A mast cell stabilizer is used cautiously during pregnancy (pregnancy category B) and lactation and in clients with impaired renal or hepatic function.
When describing the action of mast cell stabilizers, which of the following would the nurse include as being inhibited? Intracellular calcium Prostaglandins Epinephrine Slow-reacting substance of anaphylaxis
Slow-reacting substance of anaphylaxis Mast cell stabilizers work at the cellular level to inhibit the release of histamine and the release of slow-reacting substance of anaphylaxis. Epinephrine is not affected by mast cell stabilizers. Xanthines are thought to work by directly affecting the mobilization of calcium within the cell by stimulating two prostaglandins.
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 Hypotension Bradycardia Lethargy
Tachycardia Hypertension Older adults taking adrenergic bronchodilators are at increased risk for adverse reactions related to the cardiovascular system, such as tachycardia (not bradycardia), arrhythmias, palpitations, and hypertension (not hypotension). Lethargy is not related to taking adrenergic bronchodilators.
A patient with bronchial asthma is prescribed a sustained-release preparation of theophylline. To help minimize the adverse effects of the drug, which of the following should the nurse suggest? Take it on an empty stomach, 1 hour before or 2 hours after meals Take it with a meal Increase the drug dosage up to 50% Take it with foods containing xanthines, such as caffeine
Take it on an empty stomach, 1 hour before or 2 hours after meals Sustained-release preparations of theophylline should be taken on an empty stomach, 1 hour before or 2 hours after meals. Immediate-release preparations should be administered with meals to alleviate gastrointestinal distress. Foods containing xanthines, in particular caffeine, increase the effects of theophylline, but they do not help minimize the adverse effects of theophylline. Patients who smoke may require an increase in theophylline dosage of up to 50%, but increasing the dosage is not a nursing responsibility.
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." Fluticasone is an inhaled steroid and should not be used during acute asthmatic attacks. Washing linens weekly will decrease the incidence of dust mites. When clients can participate in some, but not all of usual activities, they are in the yellow zone. Once medication is inhaled, the client should hold his or her breath for 10 seconds so that medication can reach deep into the lungs.
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.) Bradycardia Airway inflammation Damaged airway mucosa Elevated temperature
Airway inflammation Damaged airway mucosa Inflammation and damaged airway mucosa are chronically present in asthma, even when clients appear symptom free.
A 27-year-old athlete with newly diagnosed asthma presents for patient education regarding situations that could precipitate an asthma attack. The nurse teaches that acute episodes of asthma may last minutes to hours. In this teaching, which precipitants would the nurse state may cause the asthma? (Select all that apply.)
Allergens Exercise Pollutants Precipitants may include allergens (e.g., pollens, molds), airway irritants and pollutants (e.g., chemical fumes, cigarette smoke, automobile exhaust), cold air, and exercise.
A client, diagnosed with asthma, is prescribed a leukotriene receptor antagonist. The nurse will discuss the importance of which diagnostic lab tests to determine how effectively the medication is being metabolized and excreted? Select all that apply. Liver function Kidney function Complete blood count Thyroid function Glucose level
Liver function Kidney function Evaluate liver and renal function tests to assess for impairments that could interfere with metabolism or excretion of the drugs. None of the other options are associated with the metabolism and excretion of this classification of medications.
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 Ensure proper placement of the endotracheal tube with bilateral chest movement and lung sounds to provide adequate delivery of the drug. Suctioning should be avoided for at least 2 hours after the surfactin is instilled into the newborn's endotracheal tube. Neither the delivery of supplemental oxygen nor position changes are related to the delivery of the medication into the infant's lungs.
A client with COPD takes theophylline. The nurse identifies that the client is still experiencing severe dyspnea. Upon review of labs, the theophylline level remains nontherapeutic. The nurse evaluates the client for which of the following drugs that may cause decreased theophylline levels? Nicotine Corticosteroids Allopurinol Cimetidine
Nicotine When combined with nicotine, theophylline levels are decreased. Allopurinol, cimetidine, and corticosteroids can increase theophylline levels.
Which teaching intervention is a priority for the client prescribed an albuterol inhaler experiencing shortness of breath related to the physiological constriction of airways?
Stop smoking due to the bronchoconstriction. Cigarette smoking will increase bronchoconstriction, so the client should be encouraged to stop. The albuterol is known to cause hand tremors as a side effect. Insulin will not decrease hand shaking. The client will not require ibuprofen since the issue is not related to inflammation. The client should be encouraged to exercise, and it should not be limited to one time per week.
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. is a 56-year-old man. has a history of pneumonia. prefers a high-calorie diet.
has a high coffee intake. Caffeine has sympathomimetic effects that may increase the risk for adverse effects with albuterol. The nurse should assess the patient's intake of caffeine through coffee, tea, soda, cocoa, candy, and chocolate. The patient's age, history of pneumonia, and preference for high-calorie food would not have important implications for his albuterol drug therapy.
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. is a 56-year-old man. has a history of pneumonia. prefers a high-calorie diet.
has a high coffee intake. Caffeine has sympathomimetic effects that may increase the risk for adverse effects with albuterol. The nurse should assess the patient's intake of caffeine through coffee, tea, soda, cocoa, candy, and chocolate. The patient's age, history of pneumonia, and preference for high-calorie food would not have important implications for his albuterol drug therapy.
