Pharmacology Chapter 55: Drugs Acting on the Lower Respiratory Tract
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."
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."
The nurse is performing a routine assessment of a client whose medical record indicates a history of asthma. What assessment findings would the nurse expect? Select all that apply. -Airway inflammation -Damaged airway mucosa -Elevated temperature -Bradycardia -Confusion
-Airway inflammation -Damaged airway mucosa
Chronic obstructive pulmonary disease (COPD) encompasses which condition? Select all that apply. -Asthma -Emphysema -Pulmonary hypertension -Chronic bronchitis -Pneumonia
-Asthma -Emphysema -Chronic bronchitis
Which of the following would be most important to assess before administering calfactant? (Select all that apply.) -Endotracheal tube placement -Bowel sounds -Lung sounds -Abdominal girth -Oxygen saturation levels
-Endotracheal tube placement -Lung sounds -Oxygen saturation levels
The nurse assesses the serum theophylline of a client. Which finding would the nurse identify as being therapeutic?
15 mcg/mL
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
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
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
A nurse is monitoring a client who is receiving theophylline 400 mg IV for severe bronchospasms, shortness of breath, and SaO2 of 85%. Which assessment finding should the nurse prioritize?
Abdominal cramps
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 patient with COPD presents at the Emergency Department (ED) in acute respiratory distress. The patient's family tells the nurse that the patient takes Atrovent and started having problems right after tasting soy milk. What would the nurse suspect is the problem?
An allergy to soy products
Which of the following would a nurse identify as a surfactant?
Beractant
What is the most common first-line therapy for relief of an acute asthma attack?
Beta2-adrenergic agonist
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 is providing education to a client who has been prescribed an antiasthmatic beta-adrenergic blocker. The nurse should instruct the client to avoid excessive intake of what beverage?
Coffee
The nursing instructor is teaching a session explaining mast cell stabilizers. The instructor determines the session is successful when the students correctly choose which drug as an example?
Cromolyn
The drug of choice for treating acute bronchospasm in both adults and children is
Epinephrine
T/F: Patients who become pregnant may safely continue taking montelukast (Singulair) for asthma
False
T/F: Premature infants are at risk for alveoli collapse because of an overproduction of surfactant, which causes the sacs to stick together
False
T/F: Sympathomimetics are drugs that mimic the effects of the sympathetic nervous system and are used for vasoconstriction
False
The client has mild, persistent asthma. The nurse anticipates the health care provider prescribing which daily medications?
Fluticasone
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
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 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 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
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
Fluticasone (Flovent) is an example of what group of drug that is helpful in decreasing the inflammatory response in the airway?
Inhaled steroids
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
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
Ipratropium (Atrovent) is contraindicated in patients with an allergy to
Peanuts and soy products
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 nurse is describing how aminophylline achieves its effect. Which would the nurse incorporate into the description?
Stimulation of the central nervous system
The nurse is providing education to a client who has been prescribed albuterol. What adverse reaction should the nurse discuss during teaching?
Tachycardia
T/F: Beractant (Survanta) should be instilled directly into the trachea and is indicated for rescue treatment of infants who have developed respiratory distress syndrome.
True
Theophylline is an example of which group of drug used in patients with asthma and COPD to improve respiratory gas exchange by dilating the airways?
Xanthines
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. -Need to avoid eating after administration -Performing strict oral hygiene -Cleaning the inhaler per package instructions -Using proper technique when administering dose -Administering a dose only every other day
-Performing strict oral hygiene -Cleansing the inhaler per package instructions -Using proper technique when administering dose
T/F: The adverse effects of xanthines are directly related to toxic concentrations of theophylline in the blood
True
Patient teaching for someone using a nebulizer should include:
Sitting upright while administering the drug