Respiratory Medication
The nurse is caring for a client wtih a diagnosis of influenza who first began to experience symptoms yesterday. Antiviral therapy is prescribed and the nurse provides instructions to the client about the therapy. Which statement by the client indicates an understanding of the instructions? 1. "I must take the medication exactly as prescribed." 2. "Once I start the medication, I will no longer be contagious." 3. "I will not get any colds or infections while taking this medication." 4. "This medication has minimal side effects and I can return to normal activities."
1. "I must take the medication exactly as prescribed" Rationale: Antiviral medications for influenza must be taken exactly as prescribed. These medications do not prevent the spread of influenza and clients are usually contagious for up to 2 days after the intiation of antiviral medicaitons. Secondary bacterial infections may occur despite antiviral treatment.
The nurse teaches a client about the effects of diphenhydramine (Benadryl), which has been prescribed as a cough suppresant. The nurse determines that the client needs further instructions if the client makes which statement? 1. "I will take the medication on an empty stomach" 2. "I won't drink alcohol while taking this medication." 3. "I will use sugarless gum, candy, or oral rinses to decrease dryness in my mouth." 4. "I won't do activities that require mental alertness while taking this medication."
1. "I will take the medication on an empty stomach." Rationale: Diphenhydramine (Benadryl) has seveal uses, including as an antihistamine, antitussive, antidyskinetic, and sedative-hypnoptic. Instructions for use include taking with food or milk to decrease gastrointestinal upset and using oral rinses or sugarless gum or hard candy to minimize dry mouth. Because the medication causes drowsiness, the client should avoid use of alcohol or central nervous system depressants, operating a car, or engaging in other activities requiring mental awareness during use.
A client has been taking isoniazid for 1 1/2 months. The client complains to the nurse about numbness, parethesias, and tingling in the extremities. The nurse interprets that the client is experiencing which problem? 1. Hypercalcemia 2. Peripheral neutritis 3. Small blood vessel spasm 4. Impaired peripheral circulation
2. Peripheral neutritis Rationale: Isoniazid is an antitubercular medication. A common side effect of isoniazid is peripheral neuritis, manifested by numbness, tingling, and paresthesias in the extremities. This can be minimized with pyridoxine (vitamin B6) intake. Options 1, 3, and 4 are incorrect.
A client is to begin a 6-month course of therapy with isoniazid. The nurse should plan to teach teh client to take which action? 1. Use alcohol in small amounts only 2. Report yellow eyes or skin immediately 3. Increase intake of Swiss or aged cheese 4. Avoid vitamin supplements during therapy
2. Report yellow eyes or skin immediately Rationale: Isoniazid is hepatotoxic, and therefore the client is taught to report signs and symptoms of hepatitis immediately, which include yellow skin and sclera. For the same reason, alcohol should be avoided during therapy. The client should avoid intake of Swiss cheese, fish, such as tuna, and foods containing tyramine because they may cause a reaction characterized by redness and itching of the skin., flushing, sweating, tachycardia, headache, or lightheadedness. The client can avoid developing peripheral neuritis by increasing the intake of pyridoxine (vitamin B6) during the course of isoniazid therapy.
The nurse has a prescription to give a client salmeterol (Serevent Diskus), two puffs, and beclomethasone dipropionate (Qvar), two puffs by metered-dose inhaler. The nurse should administer the medications using which procedure? 1. Beclomethasone first and then the salmeterol 2. Salmeterol first and then the beclomethasone 3. Alternating a single puff of each, beginning with the salmeterol 4. Alternating a single puff of each, beginning with the beclomethasone.
2. Salmeterol first and then the beclomethasone Rationale: Salmeterol (Serevent Diskus) is an adrenergic type of bronchodilator and beclomethasone dipropionate is a glucocorticoid. Bronchodilators are always administered before glucocorticoids when both are to be given on the same time schedule. This allows for widening of the air passages by the bronchodilator, which then makes the glucocorticoid more effective.
A client has been started on long-term therapy with rifampin (Rifadin). The nurse should provide which information to the client about the medication? 1.Should always be taken with food or antacids 2. Should be double-dosed if one dose is forgotten 3. Causes orange discoloration of sweat, tears, urine, and feces 4. May be discontinued independently if symptoms are gone in 3 months
3. Causes orange discoloration of sweat, tears, urine, and feces. Rationale: Rifampin should be taken exactly as directed. Doses should not be doubled or skipped. the client should not stop therapy until directed to do so by a health care provider. The medication should be administered on an empty stomach unless it causes gastrointestinal upset, and then it may be taken with food. Antacis, if prescribed, should be taken at least 1 hour before the medication. Rifampin causes orange-red discoloration of body secretions and will stain soft contact lenses permanently.
Terbutaline is prescribed for a client with bronchitis. The nurse understands that this medication should be used with caution if which medical condition is present in the client? 1. Osteoarthritis 2. Hypothyroidism 3. Diabetes mellitus 4. Polycystic disease
3. Diabetes mellitus Rationale: Terbutaline is a bronchodilator and its contraindicated in clients with hypersensitivity to sympathomimetrics. its should be used with caution in clients with impaired cardiac function, diabetes mellitus, hypertension, hyperthyroidism, or a history of seizure. The medication may increase blood glucose levels.
A client with tuberculosis is being started on anti-tuberculosis therapy with isoniazid. before giving the client the first dose, the nurse should ensure that which baselin study has been completed? 1. Electrolyte levels 2. Coagulation times 3. Liver enzyme levels 4. Serum creatinine level
3. Liver enzyme levels Rationale: Izoniazid therapy can cause an elevation of hepatic enzyme levels and hepatitis. Therefore, liver enzyme levels are monitored when therapy is initiated and during the first 5 months of therapy. They may be monitored longer in the client who is older than 50 or abuses alcohol. The laboratory tests in option 1, 2, and 4 are not necessary.
Zafirlukast (Accolate) is prescribed for a client with bronchial asthma. Which laboratory test does the nurse expect to be prescribed before the administration of this medication? 1. Platelet count 2. Neutrophil count 3. Liver function tests 4. Complete blood count
3. Liver function tests Rationale: Zafirlukast (Accolate) is a leukotriene receptor antagonist used in the prophylaxis and long-term treatment of bronchial asthma. Zafirlukast is used with caution in clients with impared hepatitis function. Liver function laboratory tests should be performed to obtain a baseline, and the levels should be monitored during administration of the medication.
The nurse is preparing to administer a dose of naloxone hydrochloride intravenously to a client with an intravenous opioid overdose. Which supportive medical equipment should the nurse plan to have at the client's bedside if needed? 1. Nasogastric tube 2. Paracentesis tray 3. Resuscitation equipment 4. Central time insertion tray
3. Resuscitation equipment Rationale: the nurse administrating naloxone for suspected opioid overdose should have resuscitation equipment readily available to support naloxone therapy if it is needed. other adjuncts that may be needed include oxygen, mechanical ventilation, and vasopressors.
A client has a prescription to take guaifenesin (Mucinex). The nurse determines that the client understands the proper administration of this medication if the client states that he or she will perform which action? 1. Take an extra dose if fever develops 2. Take the medication with meals only 3. Take the tablet with a full glass of water 4. Decrease the amount of daily fluid intake
3. Take the tablet with a full glass of water Rationale: Guaifenesin (Mucinex) is an expectorant and should be taken with a full glass of water to decrease the viscosity of secretions. Extra doses should not be taken. The client should contact the health care provider if the cough lasts longer than 1 week or its accompanied by fever, rash, sore throat, or persistent headache. Fluids are needed to decrease the viscosity of secretions. the medication does not have to be taken with meals.
The nurse has just administered the first does of omalizumab (Xolair) to a client. Which statement by the client would alert the nurse that the client may be experiencing a life-threatening effect? 1. "I have a severe headache" 2. "My feet are quite swollen." 3. "I am nauseated and may vomit." 4. "My lips and tongue are swollen."
4. "My lips and tongue are swollen" Omalizumah is an antiinflammatory used for long-term control of asthma. Anaphylactic ractions can occur with the administration of omalizumah. the nurse administrating the medication should monitor for adverse reactions of the medication. Swelling of the lips and tongue are an indication of an adverse reaction. The client statements in options 1, 2, and 3 are not indicative of an adverse reaction.
The nurse has given a client taken ethambuton (Myambuton) information about the medication. The nurse determines that the client understands the instructions if the client states he or she will immediately report which finding? 1. Impaired sense of hearing 2. Gastrointestinal side effects 3. Orange-red discoloration of body secretions 4. Difficulty in discriminating the color red from green
4. Difficulty in discriminating the color red from green Rationale: Ethambutol causes optic neuritis which decreases visual acuity and the ability to discriminate between the colors red and green. This poses a potential safety hazard when a client is driving a motor vehicle. The client is taught to report this symptom immediately. The client also is taught to take the medication with food if gastrointestinal upset occurs. Impaired hearing results from antitubercular therapy with streptomycin. Orange-red discoloration of secretions occurs with rifampin (Rifadin).
Rifabutin (Mycobutin) is prescribed for a client with active Mycobacterium avium complex (MAC) disease and tuberculosis. For which side/adverse effects of the medication should the nurse monitor? Select all that apply. 1. Signs of hepatitis 2. Flulike symptoms 3. Low neutrophil count 4. Vitamin B6 deficiency 5. Ocular pain or blurred vision 6. Tingling and numbness of the fingers
1. Signs of hepatitis 2. Flulike symptoms 3. Low neutrophil count 5. Ocular pain or blurred vision Rationale: Rifabutin (Mycobutin) may be prescribed for a client with active mycobacterium avium complex (MAC) disease and tuberculosis. It inhibits mycobacterial DNA-dependent RNA polymerase and suppresses protein synthesis. Side/adverse effects include rash, gastrointestinal disturbances, neutropenia (low neutrophil count), red-orange colored body secretions, uveitis (blurred vision and eye pain), myositis, arthralgia, hepatitis, chest pain with dyspnea, and flulike syndrome. VItamin B6 deficiency and numbness and tingling in the extremities are associated with the use of isoniazid. Ethambutol (Myambutol) causes peripheral neuritis.
A cromolyn sodium inhaler is prescribed for a client with allergic asthma. The nurse provides instructions regarding the side and adverse effects of this medication and should tell the client that which undesirable effect is associated with this medication? 1. Insomnia 2. Constipation 3. Hypotension 4. Bronchospasm
4. Bronchospasm Rationale: Cromolyn sodium is an inhaled nonsteroidal antiallergy agent and a mast cell stabilizer. Undesirable effects associated with inhalation therapy of cromolyn sodium are bronchospasm, cough, nasal congestion, throat irritation, and wheezing. Clients receiving this medication orally may experience pruritus, nausea, diarrhea, and myalgia.
A client has begun therapy with theophylline (Theo-24). The nurse should plan to teach the client to limit the intake of which items while taking this medication? 1. Coffee, cola, and chocolate 2. Oysters, lobster, and shrimp 3. Melons, oranges, and pineapple 4. Cottage cheese, cream cheese, and dairy creamers
1. Coffee, cola, and chocolate Theophylline (Theo-24) is a methylxanthine bronchodilator. The nurse teaches the client to limit the intake of xanthine-containing foods while taking this medication. These foods include coffee, cola, and chocolate.
