Chapter 55 Prep U
A male client presents to the emergency department in bronchospasm. He has a history of smoking two packs per day for 20 years and is prescribed phenytoin to control a seizure disorder that developed after a head injury 3 years ago. Based on the client's history, what would the nurse expect the health care provider to order?
A modified dose of aminophylline
Chronic obstructive pulmonary disease (COPD) encompasses which of the following? Select all that apply:
Asthma Chronic bronchitis
A client is given theophylline to treat acute asthma symptoms. Which food should the client avoid?
Chocolate
A hospital client's medication administration record specifies concurrent doses of nebulized ipratropium and albuterol at 08:00 and 20:00. When administering these drugs, the nurse should base the intervention on which fact?
The two drugs can be mixed in the nebulizer immediately before administration.
What is considered a possible trigger for an asthma attack? Select all that apply.
exercise allergens pollutants cigarette smoke
According to the National Asthma Education and Prevention Program (NAEPP) Expert Panel Guidelines, a client prescribed a short-acting beta2 agonist may take this medication how often during an acute exacerbation of asthmatic symptoms?
up to three treatments at 20-minute intervals
The first step in treating obstructive pulmonary disorders involves medication therapy.
False
A history of an allergy to which would be a contraindication to the use of anticholinergics? (Select all that apply
Soy and peanuts
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 client prescribed antiasthmatic drugs should be encouraged to avoid excessive intake of what beverage?
Coffee
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?
Contact the care provider and inform him or her that the client has toxic theophylline levels.
A nurse is required to educate a patient prescribed albuterol on the adverse effects associated with the drug. Which of the following symptoms, if experienced, should the nurse instruct the patient to report to the health care provider?
Headache and flushing
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.)
Pollutants Allergens Exercise
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
Which of the following effects would result from the action of montelukast?
Decreased eosinophil migration
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 man who smokes one pack of cigarettes daily has been diagnosed with chronic bronchitis. He has been prescribed theophylline by his family provider. What effect will the client's smoking status have on the therapeutic use of theophylline?
The client may require higher doses of theophylline than a nonsmoker
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
The client uses his sympathomimetic inhaler frequently. The nurse evaluates the client for which of the following symptoms related to frequent use of the sympathomimetic inhaler?
Nervousness
A 5-year-old boy is brought to the ED with an asthma exacerbation, including wheezing (a high-pitched, whistling sound caused by turbulent airflow through an obstructed airway). Those who have asthma chronically present with what signs, even when they may appear symptom free? (Select all that apply.)
Airway inflammation Damaged airway mucosa
A male client presents with symptoms of bronchospasm that occurred during a birthday party for his grandson. What medication would the nurse expect the health care provider to give the client?
Albuterol
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
A client recently began taking theophylline for treatment of asthma. Which changes in the client's lifestyle would suggest that the client understands proper use of the drug and management of the disease?
Avoidinf caffine
A client recently began taking theophylline for treatment of asthma. Which changes in the client's lifestyle would suggest that the client understands proper use of the drug and management of the disease?
Avoiding caffine
The nurse should complete which of the following during acute breathing distress before initiation of a broncodilator? Select all that apply:
Check blood pressure. Check pulse. Check respiratory rate
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 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
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
An 8-year-old client reports shortness of breath, cough, and chest tightness when participating in gym class. The client is diagnosed with exercise-induced asthma. What inhaled drug therapy is the health care provider most likely to prescribe?
Formoterol (Foradil), a highly selective beta-2 agonist
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
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 client with asthma is administered zileuton along with theophylline. The nurse should be especially alert for which of the following?
Increased serum theophylline
The triage nurse in the emergency department has a 42-year-old client with asthma present for treatment. The client's respiratory rate is 40 breaths per minute. Based on this objective data, what is the correct nursing diagnosis for this client?
Ineffective breathing pattern
A client is prescribed salmeterol. The nurse would expect this drug to be administered by which route?
Inhalation
A nurse is administering levalbuterol to a client. The nurse would administer this drug by which route?
Inhalation
How do inhaled corticosteroid agents assist in the treatment of asthma?
Inhaled corticosteroid agents will reduce airway inflammation.
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
Which medication is used to treat acute airflow obstruction?
Metaproterenol
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
While reviewing a client's history, an allergy to which of the following would alert the nurse to a possible problem with the use of ipratropium?
Peanuts
The client with asthma has been ordered an inhaler and the nurse is teaching how to prevent Candida infections. Which would the nurse include in the instructions?
Rinse mouth with water after each use.
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
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 providing care for a newborn who has received an instillation of surfactin. What assessment data indicates the infant is experiencing adequate oxygen perfusion? Select all that apply.
Skin is pink over entire body Skin warm to the touch
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
Cromolyn should not be used during an acute asthmatic attack.
True
Leukotriene receptor antagonists are administered orally.
True
A client diagnosed with asthma is being prescribed a leukotriene receptor antagonist as part of their mediation therapy. The nurse should encourage the client to report incidence of what events as possible adverse effects of the new medication? Select all that apply.
diarrhea headache fever muscle aches
Adrenergics are a category of bronchodilators used in the treatment of asthma and chronic obstructive pulmonary disease (COPD). In what conditions is cautious use of these drugs recommended? Select all that apply.
hypertension seizure disorders diabetes mellitus
The nurse is teaching a client newly diagnosed with asthma about triggers. Which statement by the client indicates the client understands the teaching plan?
"I will use my air conditioner."
Which statement made by a nurse providing care to a newborn prescribed surfactin therapy indicates a need for additional instructions to ensure the medication's effectiveness?
"The baby requires suctioning every 1 hour for 4 hours after the instillation of surfactant."
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 is receiving ipratropium as maintenance therapy for chronic obstructive pulmonary disease. The nurse would caution the client that up to how many inhalations may be used in 24 hours if needed?
12
The nurse assesses the serum theophylline of a client. Which finding would the nurse identify as being therapeutic?
15 mcg/mL
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 min prior to exercising
A client who is experiencing anaphylaxis with severe wheezing receives a dose of epinephrine intravenously. The nurse would expect the drug to exert it full effects within which time frame?
20 minutes
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
Tom, age 42, is prescribed ipratropium bromide as an anticholinergic agent for treating asthma. The nurse caring for Tom needs to develop a plan of care. What must be included in the plan? Select all that apply.
Advise the patient to avoid using ipratropium if allergic to soybeans, legumes, or soya lecithin. Remind the patient that ipratropium must be taken daily, despite the absence of symptoms of asthma.
A 5-year-old boy is brought to the ED with an asthma exacerbation, including wheezing (a high-pitched, whistling sound caused by turbulent airflow through an obstructed airway). Those who have asthma chronically present with what signs, even when they may appear symptom free? (Select all that apply.)
Airway inflammation Damaged airway mucosa
The parents of a 7-year-old client who has been diagnosed with allergic asthma are being taught about their son's medication regimen. The nurse is teaching about the appropriate use of a "rescue drug" for acute exacerbations. What drug should the nurse suggests the parents to use in these situations?
Albuetrol
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
The parents of a 7-year-old client who has been diagnosed with allergic asthma are being taught about their son's medication regimen. The nurse is teaching about the appropriate use of a "rescue drug" for acute exacerbations. What drug should the nurse suggests the parents to use in these situations?
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
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 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
A nurse would expect to increase the dosage of theophylline if the client has a current history of which of the following?
Cigarette smoking
When teaching a client about his prescribed asthma therapy, the nurse understands that which medications may increase the risk of asthma-related death?
Long-acting beta-2 agonists
A male client is prescribed montelukast and uses it successfully to manage his asthma. He develops hepatitis C. What would the nurse expect the health care provider to do?
Maintain the same dose of the montelukast
What is the most common first-line therapy for relief of an acute asthma attack?
beta2-adrenergic agonist
After teaching a group of students about zafirlukast, the students demonstrate understanding when they identify which as possible adverse effects? (Select all that apply.)
Myalgia Dizziness Vomiting
A child prescribed an inhaled corticosteroid agent to decrease respiratory inflammation is now receiving high doses of the drug after only 2 days of treatment. What adverse reaction is the client at risk for developing?
Adrenal insufficency
Which of the following would a nurse identify as a surfactant?
Beractant
