Respiratory Pharmacology

The nurse has just administered the first dose of omalizumab to a client. Which statement by the client would alert the nurse that the client may be experiencing a life-threatening effect?

"My lips and tongue are swollen."

A client with chronic obstructive pulmonary disease (COPD) is being changed from an oral glucocorticoid to triamcinolone by inhalation. The client asks why this change is necessary. Which statement by the nurse to the client is accurate?

"Inhaled glucocorticoids are preferred because of decreased adverse effects."

A postpartum nurse is caring for a client with an epidural catheter in place for opioid analgesic administration following cesarean birth. The client develops respiratory depression and requires naloxone administration. Which finding should the nurse anticipate as a result of the naloxone administration?

Increase in pain level

The nurse is administering a dose of pirbuterol to a client. The nurse should monitor for which side or adverse effect of this medication?

Increased pulse

Cromolyn sodium is prescribed for the client with allergic asthma. What goal does the nurse expect to achieve by administration of this medication?

Inhibition of the release of mediators from mast cells after exposure to an antigen

Zafirlukast is prescribed for a client with bronchial asthma. Which laboratory test does the nurse expect to be prescribed before the administration of this medication?

Liver function tests

A client is scheduled to receive acetylcysteine 20% solution diluted in 0.9% normal saline by nebulizer. Which outcome would the nurse expect as a result of the administration of this medication?

Thinning of respiratory secretions

The client has a prescription to receive pirbuterol 2 puffs and beclomethasone dipropionate 2 puffs by metered-dose inhaler. The nurse plans to give these medications in which way to ensure effectiveness?

Administering the pirbuterol before the beclomethasone

A client has begun using a methylxanthine bronchodilator. What beverage should the nurse plan to teach the client to avoid while taking this medication?

Coffee

The nurse has a prescription to give a client salmeterol, 2 puffs, and beclomethasone dipropionate, 2 puffs, by metered-dose inhaler. The nurse should administer the medication using which procedure?

Salmeterol first and then the beclomethasone

Which supplies should the nurse obtain for the administration of ribavirin to a hospitalized child with respiratory syncytial virus (RSV)?

A mask and pair of goggles

A client with an exacerbation of chronic obstructive pulmonary disease (COPD) has been on oral glucocorticoids and is currently being weaned to triamcinolone by inhalation. The nurse determines that the client understands the potential adverse effects to watch for during this medication change when the client states the need to report which signs and symptoms?

Anorexia, nausea, weakness, and fatigue

The nurse is preparing to administer a dose of naloxone intravenously to a client with an opioid overdose. Which supportive medical equipment should the nurse plan to have at the client's bedside if needed?

Resuscitation equipment

The nurse should monitor the client receiving the first dose of albuterol for which side or adverse effect of this medication?

Tachycardia

A client is taking a prescribed course of therapy with ethambutol. The home health nurse assesses the client at each home visit for which adverse effect of this medication?

Visual disturbances

A cromolyn sodium inhaler is prescribed for a client with allergic asthma. The nurse provides instructions regarding the adverse effects of this medication and should tell the client that which undesirable effect is associated with this medication?

Bronchospasm

A client receiving oral theophylline is due to have a theophylline level drawn. The nurse should question the client to ensure that the client has not ingested which substance before the blood sample is drawn?

Coffee

A client who experiences allergic rhinitis asks the nurse about a nasal corticosteroid. How should the nurse reply?

"The medication works locally and decreases inflammation."

A client taking albuterol by inhalation cannot cough up secretions. What should the nurse suggest that the client do to assist in expectoration of secretions?

Drink increased amounts of fluids every day.

A client is taking cetirizine. The nurse should inform the client of which side effect of this medication?

Drowsiness

A client with a prescription to take theophylline daily has been given medication instructions by the nurse. What statement by the client indicates the need for further education regarding the prescription?

"I will take the daily dose at bedtime."

A client who has been receiving theophylline by the intravenous (IV) route has the medication prescription changed to an immediate-release oral form of the medication. After discontinuing the IV medication, when should the nurse schedule the first dose of the oral medication?

4 hours after discontinuing the IV form

The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is receiving theophylline. The nurse monitors the serum theophylline level and concludes that the medication dosage may need to be increased if which value is noted?

5 mg/mL (20 mcmol/L)

Ribavirin is prescribed for a hospitalized child with severe respiratory syncytial virus (RSV). The nurse prepares to administer this medication via which route?

Oxygen tent

A client has been taking isoniazid for 2 months. The client complains to the nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing which problem?

Peripheral neuritis

The health care provider prescribes cromolyn for the client with asthma. The nurse identifies that the client correctly understands the purpose of this medication when the client states that the medication will produce which effect?

Suppress an allergic response

A client diagnosed with active tuberculosis has been prescribed a combination of isoniazid and rifampin for treatment. The nurse teaches the client to perform which action?

Take both medications together once a day.

A client has a prescription to take guaifenesin. The nurse determines that the client understands the proper administration of this medication if the client states that he or she will perform which action?

Take the tablet with a full glass of water.

A client has a prescription to take guaifenesin. The nurse should conclude that the client understands the most effective use of this medication if the client states that they need to take which action?

Take the tablet with a full glass of water.

The nurse has given a client taking ethambutol information about the medication. The nurse determines that the client understands the instructions if the client states that he or she will immediately report which finding?

Difficulty in discriminating the color red from green

Rifabutin is prescribed for a client with active Mycobacterium avium complex (MAC) disease and tuberculosis. For which side and adverse effects of the medication should the nurse monitor? Select all that apply.

Signs of hepatitis 2. Flulike syndrome 3. Low neutrophil count Ocular pain or blurred vision

Which is the nurse's priority assessment for monitoring for adverse effects for the client taking isoniazid?

Urine color

A client has begun a course of therapy with rifampin. The home care nurse instructs the client on which measure due to an anticipated side effect?

Wear dark clothing to avoid staining.

A client with tuberculosis (TB) has a prescription for rifampin. What instruction should the nurse include in the client's teaching plan?

Wearing glasses instead of soft contact lenses will be necessary.

Terbutaline is prescribed for a client with bronchitis. The nurse checks the client's medical history for which disorder in which the medication should be used with caution?

Diabetes mellitus

A clinic nurse is assessing a client who has been on isoniazid for 6 months. Which client complaint should most concern the nurse?

Difficulty tying shoes

A client taking theophylline has a serum theophylline level of 15 mcg/mL (60 mcmol/L). How does the nurse interpret this laboratory value?

In the middle of the therapeutic range

The nurse would anticipate that the health care provider (HCP) would add which medication to the regimen of the client receiving isoniazid?

Pyridoxine

The nurse is teaching a client about the effects of diphenhydramine, an ingredient in the cough suppressant prescribed for the client. The nurse should plan to tell the client to take which measure while taking this medication?

Avoid activities requiring mental alertness.

Isoniazid is prescribed for a child with human immunodeficiency virus (HIV) infection who has a positive tuberculin skin test result. The mother of the child asks the nurse how long the child will need to take the medication. For how long should the nurse tell the mother the medication will need to be taken?

12 months

The client questions the nurse as to why the health care provider switched the usual prescription from a metered-dose inhaler (MDI) to a dry powder inhaler (DPI). The nurse should respond correctly by providing which facts? Select all that apply.

Dry powder inhalers pose no environmental risks. Dry powder inhalers deliver more medication to the lungs. 5. Dry powder inhalers require less hand-to-lung coordination.

The nurse is preparing to administer albuterol to a client. Which parameters should the nurse assess before and during therapy?

Lung sounds and presence of dyspnea

A home care nurse has observed a client self-administer a dose of an adrenergic bronchodilator via metered-dose inhaler. Within a short time, the client begins to wheeze loudly. The nurse understands that this is the result of which occurrence?

Paradoxical bronchospasm, which must be reported to the health care provider (HCP)

A client is to begin a 6-month course of therapy with isoniazid. The nurse should plan to teach the client to take which action?

Report yellow eyes or skin immediately.

A client has been taking pyrazinamide for 6 months. The nurse determines that the medication is effective if which cultures yield a negative result?

Sputum

A client has been taking pyrazinamide for 1 month. The client asks the nurse whether the therapy is due to be terminated soon. The nurse determines that the medication probably will be continued based on a positive finding in which report?

Sputum culture

A client with tuberculosis receiving cycloserine orally twice daily must have blood drawn in 1 week to measure the serum concentration of the medication. The nurse prepares the client for this test by providing which information to the client?

Take the morning dose and have the blood drawn 2 hours after taking the dose.

The nurse is caring for a client with a diagnosis of influenza who first began to experience symptoms yesterday. Antiviral therapy is prescribed and the nurse provides instructions to the client about the therapy. Which statement by the client indicates an understanding of the instructions?

"I must take the medication exactly as prescribed."

When evaluating an asthmatic client's knowledge of self-care, the nurse recognizes that additional instruction is needed when the client makes which statement?

"I use my corticosteroid inhaler each time I feel short of breath."

The nurse teaches a client about the effects of diphenhydramine, which has been prescribed as a cough suppressant. The nurse determines that the client needs further instruction if the client makes which statement?

"I will take the medication on an empty stomach."

Which statement made by a client taking montelukast indicates the need for further teaching?

"I will take the medication when I first notice I am having trouble breathing."

A client has been given a prescription for benzonatate. Which observation should the nurse look for to evaluate the effectiveness of the medication?

Calming the client's persistent cough

A client has been started on long-term therapy with rifampin. The nurse should provide which information to the client about the medication?

Causes orange discoloration of sweat, tears, urine, and feces

A client taking rifampin reports, "My urine has blood in it." When the nurse assesses the urine, it is brown. Which is the nurse's best action?

Chart the finding as a normal response to the rifampin.

A client has begun therapy with theophylline. The nurse should plan to teach the client to limit the intake of which items while taking this medication?

Coffee, cola, and chocolate

The health care provider (HCP) has prescribed codeine sulfate for a client with a nonproductive cough to suppress the cough reflex. The nurse should teach the client to monitor for which side effect of the medication?

Constipation

The nurse is administering a dose of morphine sulfate to a client via an epidural catheter after nephrectomy. Before administering the medication, what should the nurse plan to do?

Ensure that naloxone is readily available.

A client has begun therapy with a xanthine bronchodilator. The nurse determines that the client understands dietary alterations if the client states to limit which items while taking this medication? Select all that apply.

coffee chocolate

A client with tuberculosis is being started on antituberculosis therapy with isoniazid. Before giving the client the first dose, the nurse should ensure that which baseline study has been completed?

Liver enzyme levels

A client with a documented exposure to tuberculosis is on medication therapy with isoniazid. The nurse is monitoring laboratory results and determines that which laboratory value indicates the need for follow-up?

Aspartate aminotransferase (AST) 55 U/L (55 U/L)