Chapter 55: Drugs Acting on the Lower Respiratory Tract

Which statement by a client who is prescribed triamcinolone indicates the need for additional teaching?

"I should see some results in about 3 to 4 days."

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

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

A patient has been admitted to a health care facility with asthma. The nurse is advised to administer theophylline to the patient. To which patients can the nurse safely administer theophylline?

A 65-year-old male patient with asthma

A patient with acute respiratory symptoms is receiving a loading dose of theophylline. Which of the following signs of toxicity should alert the nurse to notify the primary health care provider immediately?

Abdominal cramps

Which is an example of a short-acting beta-2 agonist (SABA)?

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 asthmatic client 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

Chronic obstructive pulmonary disease (COPD) encompasses which of the following? Select all that apply:

Asthma Chronic bronchitis

Which of the following would a nurse identify as a surfactant?

Beractant

A patient is experiencing an acute asthma attack. What is the first-line therapy for relief of an acute asthma attack?

Beta2-adrenergic agonist

What does stimulation of alpha-adrenergic receptors result in?

Bronchoconstriction

A patient is given theophylline to treat acute asthma symptoms. Which of the following foods should the patient avoid?

Chocolate

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 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

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.)

Exercise Allergens Pollutants

The first step in treating obstructive pulmonary disorders involves medication therapy.

False

After teaching a group of students about leukotriene receptor antagonists, the instructor determines a need for additional teaching when the students identify which agent as an example?

Fluticasone

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

Hold breath for 10 seconds. Inhale quickly.

A patient with asthma is administered zileuton along with theophylline. For which drug interaction should the nurse monitor the patient?

Increased serum theophylline

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

Inhalation

A patient is instructed on the administration of inhaled corticosteroid agents to treat asthma. How do inhaled corticosteroid agents assist in the treatment of asthma?

Inhaled corticosteroid agents will reduce airway inflammation.

A patient, diagnosed with asthma, has been prescribed tiotropium. What should the nurse know about tiotropium? (Mark all that apply.)

It is an anticholinergic You only need to take it once a day It has a rapid onset of action and a long duration

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

What is used to treat acute air flow obstruction?

Metaproterenol (Alupent)

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

Which of the following would be most important to assess before administering calfactant? (Select all that apply.)

Oxygen saturation levels Endotracheal tube placement Lung sounds

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?

SABA

When describing the action of mast cell stabilizers, which of the following would the nurse include as being inhibited?

Slow-reacting substance of anaphylaxis

A history of an allergy to which would be a contraindication to the use of anticholinergics? (Select all that apply.)

Soy Peanuts

Xanthine derivatives elicit their effect by which mechanism?

Stimulation of the central nervous system

A patient is using an albuterol (Proventil) inhaler, which is a bronchodilator. Which patient teaching intervention is important for the patient who is experiencing shortness of breath related to constriction of airways?

Stop smoking due to the bronchoconstriction

In children, high doses of nebulized albuterol have been associated with what conditions? (Select all that apply.)

Tachycardia Hypokalemia Hyperglycemia

Cromolyn should not be used during an acute asthmatic attack.

True

A patient is being assessed by the home care nurse on the administration of the inhalers. Which will assist in proper administration of the inhaler?

Use of a spacer

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

When educating a group of students on the mechanism of action of various anti-asthma drugs, the nurse identifies which drug as inhibiting the formation of leukotriene?

Zileuton

The client's theophylline levels are increased. The nurse questions the client about his intake of:

coffee

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.

The nurse should teach the student that overuse of albuterol can lead to

rebound bronchoconstriction.

A patient is being assessed by the home care nurse on the administration of the inhalers. Which will assist in proper administration of the inhaler?

use of a spacer