pharm chapter 55
What medical condition is likely to be exacerbated by the medication therapy associated with asthma? gastroesophageal reflux disease (GERD) urinary retention cataracts dermatitis
gastroesophageal reflux disease (GERD)
The nurse assesses the serum theophylline of a client. Which finding would the nurse identify as being therapeutic? 30 mcg/mL 15 mcg/mL 25 mcg/mL 5 mcg/mL
15 mcg/mL
A patient who is prescribed ipratropium administers the drug at 9:15 AM. The patient should begin to notice the drug beginning to act at which time? 9:45 AM 10:15 AM 9:30 AM 10:00 AM
9:30 AM
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)? Formoterol Salmeterol Albuterol Arformoterol
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 Pneumonia Chronic bronchitis Emphysema
Asthma
Which of the following would a nurse identify as a surfactant? Cromolyn Zileuton Beractant Theophylline
Beractant
A client is experiencing an acute asthmatic attack. Which agent would be most effective? Inhaled steroid Leukotriene receptor antagonist Mast cell stabilizer Beta-2 selective adrenergic agonist
Beta-2 selective adrenergic agonist
A client is given theophylline to treat acute asthma symptoms. Which food should the client avoid? Bananas Chocolate Cranberry juice Orange juice
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 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? Salt Coffee Vitamin C Alcohol
Coffee
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 Cheese Tea Carrots
Coffee
Which medication is used to treat acute airflow obstruction? Azelastine Montelukast Metaproterenol Beclomethasone
Metaproterenol
A client with asthma should always carry a rescue inhaler or quick-relief medication with them at all times. Which of the following are considered quick-relief medications? Select all that apply: Salmeterol (Serevent) Metaproterenol (Alupent) Tiotropium (Spiriva) Formoterol (Foradil) Albuterol (Proventil)
Metaproterenol (Alupent) Albuterol (Proventil)
After teaching a group of students about antiasthmatic agents, the students demonstrate understanding of the information when they identify what as sympathomimetics? (Select all that apply.) Cromolyn Terbutaline Formoterol Tiotropium Epinephrine Budesonide
Epinephrine Terbutaline Formoterol
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? Zafirlukast Fluticasone Montelukast Zileuton
Fluticasone
An older adult client has been prescribed an inhaled corticosteroid for the treatment of chronic obstructive pulmonary disease (COPD). Which action should the nurse perform to reduce the client's risk for developing oral candidiasis? Have the client gargle with normal saline prior to administering the drug. Have the resident rinse his or her mouth after each dose of the drug. Encourage the resident not to deeply inhale the medication. Administer prophylactic antifungal medications.
Have the resident rinse his or her mouth after each dose of the drug.
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? Bradycardia Nervousness Fatigue Hypotension
Nervousness
Why are inhaled steroids used to treat asthma and COPD? They act locally to increase histamine release They act locally to decrease release of inflammatory mediators They act locally to decrease histamine release They act locally to improve mobilization of edema
They act locally to decrease release of inflammatory mediators
The nurse teaching a client about theophylline will include the identification of which possible symptoms of toxicity? agitation and arrhythmias Chest pain and shortness of breath Confusion and decreased level of consciousness Polyuria and polyphagia
agitation and arrhythmias
The nurse should be aware that concomitant use of what drug is contraindicated during tiotropium therapy? budesonide theophylline ipratropium fluticasone
ipratropium
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."
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? "I need to inhale my medication and hold my breath for 10 seconds." "I will wash my sheets weekly." "When I can do some, but not all of my usual activities, I am in the yellow zone." "When I am short of breath, I will increase the use of my fluticasone."
'When I am short of breath, I will increase the use of my fluticasone."
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? Right before and after exercising 15 minutes before engaging in exercise Immediately after beginning to exercise Midway during the exercise routine
15 minutes before engaging in exercise
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 One hour before exercise Immediately on beginning to exercise In the morning of the day when exercise is planned
15 minutes prior to exercising
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 drug other than aminophylline Phenytoin intravenously A modified dose of aminophylline The standard dose of aminophylline
A modified dose of aminophylline
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 Omalizumab Epinephrine Salmeterol
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 blocks the stimulation of the beta-2 receptors. Albuterol causes relaxation of the bronchial smooth muscles. Albuterol decreases vital capacity. Albuterol causes stimulation of the bronchial tissue.
Albuterol causes relaxation of the bronchial smooth muscles.
A nurse would expect to increase the dosage of theophylline if the client has a current history of which of the following? Cigarette smoking Gastrointestinal upset Alcohol intake Hyperthyroidism
Cigarette smoking
Where should the nurse initially direct a client who is interested in learning more about the management of asthma? Journal of Allergy and Clinical Immunology Centers for Disease Control Education Center Global Initiative for Asthma (GINA) National Association of Educational Pulmonologists
Global Initiative for Asthma (GINA)
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 airway clearance Impaired gas exchange Ineffective breathing pattern Activity intolerance
Ineffective breathing pattern
A client is prescribed salmeterol. The nurse would expect this drug to be administered by which route? Subcutaneous Oral Inhalation Intravenous
Inhalation
A neonate is receiving beractant. The nurse understands that this agent is administered by which route? Intravenous Intramuscular Intratracheal Subcutaneous
Intratracheal
An 8-year-old child with an acute asthmatic attack is receiving metaproterenol via nebulizer. Which of the following would be most appropriate? Have the child lie flat. Encourage rapid shallow breaths. Turn the device off when the mist slows. Mix the drug with saline.
Mix the drug with saline.
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? Penicillin Peanuts Aspirin Ragweed pollen
Peanuts
A client, experiencing respiratory distress related bronchi constriction, will benefit from what therapeutic action provided by anticholinergic medication therapy? Decrease in the production of leukotrienes D4 and E4 Reduction of the inflammatory response Relaxation of smooth muscle Enhancement of alveolar expansion
Relaxation of smooth muscle
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? Leukotriene modifier SABA LABA Antiasthma
SABA
A client is being assessed by the home care nurse for the appropriate use of a metered-dose inhaler. Instructions concerning which intervention will assist a client in the proper use of the device? Administrating corticosteroid first Exhaling immediately after administration Using a spacer Pushing fluids
Using a spacer
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? Shellfish Peanuts Dairy Eggs
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 should take a deep breath, hold it while I administer the medication, and then exhale." "I need to shake the inhaler well before taking the medication." "I need to wait at least 30 minutes after the first inhalation before taking a second." "I need to take three short, quick breaths to inhale the medication."
"I need to shake the inhaler well before taking the medication."
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? "This is a new kind of asthma medication." "I need to take the medication when I start to have problems breathing." "This medication is safe for kids like me." "We need to let the health care provider know if the medicine gives me a headache or makes me dizzy."
"I need to take the medication when I start to have problems breathing."
A client with asthma has been prescribed an albuterol inhaler. What recommendation should the nurse include in client teaching? "Stop smoking to reduce bronchoconstriction." "Immediately stop using the inhaler if you experience hand shaking." "Take ibuprofen to decrease inflammation associated with the condition." "Limit exercise to one session per week."
"Stop smoking to reduce bronchoconstriction."
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 Acetylcysteine Beclomethasone Theophylline
Albuterol
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.) Allergens Exercise Pollutants Warm weather
Allergens Exercise Pollutants
A patient tells you that a friend of theirs has recommended the use of caffeine to treat the patient's asthma. What would be the most important reason a nurse should counsel this patient not to delay prescribed treatment for the use of natural health products? Delays in appropriate treatment can have serious, even fatal, consequences Natural products decrease the adverse effects associated with adrenergic bronchodilators Caffeine can aggravate the drugs used to treat asthma Most natural products are less toxic or more potent than traditional asthma medications
Delays in appropriate treatment can have serious, even fatal, consequences
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 make sure I don't take my inhalers more often than they've been prescribed." "I'll try to make sure that I drink plenty of fluids each day." I'll keep taking my medications until I'm not experiencing any more symptoms." "I'm a heavy coffee drinker, but I know that I now know I need to cut down on this."
I'll keep taking my medications until I'm not experiencing any more symptoms."
Mark, 8 years old, is prescribed flunisolide. The physician advises Mark and his parents to use a spacer when administering this medication. What is the benefit of such use? It reduces the risk of tachycardia. It helps decrease systemic absorption. It helps decrease the intrapulmonary delivery of the drug. It reduces the risk of sinusitis.
It helps decrease systemic absorption.
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? Changing the newborn's position frequently to assure effective distribution of medication Supply supplemental oxygen as prescribed Monitoring respirations for bilateral chest movement Suctioning the infant every 30 minutes for 2 hours after the treatment has been initiated
Monitoring respirations for bilateral chest movement
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? The extra doses facilitated bronchodilation and probably saved her life. Salmeterol is contraindicated based on his wife's condition. The health care provider will most likely order continuation of the salmeterol with increased dosage. The husband made the correct decision in giving the extra doses.
Salmeterol is contraindicated based on his wife's condition.
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 history of pneumonia. has a high coffee intake. prefers a high-calorie diet. is a 56-year-old man.
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 community-acquired pneumonia. severe anticholinergic effects. rebound bronchoconstriction. permanent liver damage.
rebound bronchoconstriction.
