Chapter 55: COURSE POINT

A female client is prescribed systemic corticosteroids for her asthma. The nurse knows that the client is at risk for what problem?

Adrenal insufficiency

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

One method of reducing bronchoconstriction is removing excessive secretions from the respiratory tract. Patients can take several actions on their own to help manage secretions. Which will not help manage secretions?

Asking the physician to prescribe inhaled corticosteroids

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

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?

"I need to take the medication when I start to have problems breathing."

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 client with asthma has received two doses of theophylline. After analyzing the daily serum theophylline level, the nurse determines the client has achieved a therapeutic level with which result?

13 mcg/L

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

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 experiencing an acute asthmatic attack. Which agent would be most effective?

Beta-2 selective adrenergic agonist

What is the most common first-line therapy for relief of an acute asthma attack?

Beta2-adrenergic agonist

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

Chocolate

The nursing instructor is teaching a session explaining the various drugs used to treat chronic obstructive pulmonary disease (COPD). The instructor determines the session is successful when the students correctly choose which condition(s) as being considered part of the COPD spectrum? Select all that apply.

Chronic bronchitis Asthma

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 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

Where should the nurse initially direct a client who is interested in learning more about the management of asthma?

Global Initiative for Asthma (GINA)

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."

A neonate is receiving beractant. The nurse understands that this agent is administered by which route?

Intratracheal

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

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

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.

The health care provider has prescribed a monoclonal antibody for a client with asthma. The nurse will prepare a teaching plan for which medication?

Omalizumab

A patient presents at the Emergency Department (ED) in acute respiratory distress. A quick assessment by the triage nurse indicates that the patient experienced difficulty breathing immediately after taking Combivent for the first time. The nurse suspects that the patient may be allergic to what?

Peanuts

The nurse teaches a client receiving an inhaled corticosteroid about the possibility of developing oral thrush. Which action(s) would the nurse include in the teaching plan as a way to reduce this risk? Select all that apply.

Performing strict oral hygiene Cleaning the inhaler per package instructions Using proper technique when administering dose

A client with a diagnosis of asthma has been prescribed ipratropium 2 puffs QID. What is the most likely goal of this treatment?

Promoting long-term management of asthma symptoms

A client receiving aminophylline reports heartburn on assessment to the nurse. What is the best response by the nurse?

Raise the head of the bed.

The health care provider has ordered epinephrine for a client admitted emergently with bronchospasms. The nurse will prepare to administer this drug via which route?

Subcutaneous

The nurse is providing education to a client who has been prescribed albuterol. What adverse reaction should the nurse discuss during teaching?

Tachycardia

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.

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 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

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 client has been prescribed a inhaled steroid for the treatment of asthma. What information should the nurse include when providing medication education to the client? Select all that apply.

The medication is not intended to treat an acute asthma attack Abruptly stopping any previously prescribed systemic steroid could cause an adrenal insufficiency Rebound nasal congestion is a adverse effect of this form of medication Promptly report a fever or any other indication of infection to your health provider

Why are inhaled steroids used to treat asthma and COPD?

They act locally to decrease release of inflammatory mediators

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

The nurse is providing education to the parents of a child who has been newly diagnosed with asthma. During teaching, the nurse should explain that asthma attacks occur when mast cells release substances that cause what reaction?

inflammation

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?

Increase

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 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.

After teaching a group of students about drugs as bronchodilators, the instructor determines that the teaching has been successful when the students identify which group of drugs as once being first-line agents?

Xanthines

A client has been prescribed medication therapy for the treatment of newly diagnosed asthma. During teaching, the nurse should alert the client to potential exacerbation of what concurrent medical condition?

gastroesophageal reflux disease