Chapter 55: Drugs Acting on the Lower Respiratory Tract 1 quizzes taken

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.

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 will use this medication when I am having an asthma attack."

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.

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 Albuterol for exercise induced bronchospasm should be administered 15 minutes prior to exercising.

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.

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

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.

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?

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

Cigarette smoking Nicotine increases the metabolism of xanthines; therefore, an increased dosage would be necessary. Hyperthyroidism, gastrointestinal, upset or alcohol intake requires cautious use of the drug because these conditions may be exacerbated by the systemic effects of the drug. The drug dosage may need to be decreased in these situations.

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 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.

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.

Leukotriene receptor antagonists are administered orally.

True

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

beta2-adrenergic agonist

A client prescribed antiasthmatic drugs should be encouraged to avoid excessive intake of what beverage?

coffee Clients taking antiasthmatic drugs should generally avoid excessive intake of caffeine-containing fluids such as coffee, tea, and cola drinks. These beverages may increase bronchodilation but also may increase heart rate and cause palpitations, nervousness, and insomnia with bronchodilating drugs. None of the other options contain sufficient amounts of caffeine to cause such an affect.

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. 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.

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.

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 The client should be instructed to use a spacer to increase compliance and accuracy of administration. An asthma spacer is an add-on device used to increase the ease of administering aerosolized medication from a metered-dose inhaler (MDI). The corticosteroid should be administered after the bronchodilator. The increase in fluids will not affect the administration of the inhaler. The client should hold his or her breath for several seconds after administration of the inhaler.