Nokea
A client has been admitted to a health care facility with acute bronchospasm. The primary health care provider prescribes the drug epinephrine. The nurse anticipates administering this drug by which route?
- A. Intravenous
- B. Intramuscular
- C. Subcutaneous
- D. Intradermal
Correct Answer: C
Rationale: The nurse should use the subcutaneous route to administer epinephrine for acute bronchospasm. Doses of epinephrine are measured in tenths of a milliliter. A tuberculin syringe is used for measuring and administering these drugs by the parenteral route. The other routes are not appropriate for this situation.
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The nurse is reviewing the history of a client who is prescribed a long-acting beta-2 agonist. Which of the following would alert the nurse to the need to administer this drug cautiously to the client? Select all that apply.
- A. Hyperlipidemia
- B. Hypertension
- C. Glaucoma
- D. Hyperthyroidism
- E. Diabetes
Correct Answer: B,C,D,E
Rationale: Long-acting beta-2 agonists should be used cautiously in clients with hypertension, cardiac dysfunction, hyperthyroidism, glaucoma, diabetes, prostatic hypertrophy, and history of seizures.
A nurse is caring for a 30-year-old client who is receiving albuterol for asthma. The client complains of feeling dizzy, especially when he stands up after sitting. The nurse suspects that a possible interaction with another drug could be causing the client's problem. Which of the following drugs should the nurse consider as a possible cause?
- A. Warfarin
- B. Uterine stimulants
- C. Methylxanthines
- D. Methyldopa
Correct Answer: D
Rationale: The nurse should consider methyldopa as a cause for the client's complaint of dizziness on standing, suggesting hypotension. Methyldopa and albuterol interact, leading to hypotension. Albuterol does not interact with warfarin. Interaction between albuterol and uterine stimulants leads to severe hypotension, and not severe headache. There is an increased risk of cardiotoxicity when methylxanthines are given along with albuterol.
After teaching a group of nursing students about xanthine derivatives, the instructor determines that the teaching was successful when the students state which of the following? Select all that apply.
- A. Xanthine derivatives cause flushing.
- B. The action of xanthine derivatives leads to bradycardia.
- C. Xanthine derivatives cause a reduction in airway inflammation.
- D. Xanthine derivatives cause hypoglycemia.
- E. Xanthine derivatives stimulate the CNS to promote bronchodilation.
Correct Answer: A,E
Rationale: Xanthine derivatives can cause flushing, tachycardia, and hyperglycemia. Xanthine derivatives elicit their effects by stimulating the CNS to promote bronchodilation.
A nurse is providing care to a client receiving theophylline. The client has received two loading doses and the nurse is evaluating the client's theophylline levels. Which finding would the nurse interpret as a therapeutic drug level?
- A. 5 mcg/L
- B. 8 mcg/L
- C. 13 mcg/L
- D. 20 mcg/L
Correct Answer: C
Rationale: Therapeutic theophylline levels range from 10 to 20 mcg/L. The possibility of toxicity increases with levels over 15 mcg/L, with toxicity indicated with levels over 20 mcg/L.
A pediatric client is prescribed cromolyn. The nurse understands that this drug can be administered in which manner? Select all that apply.
- A. Via a nebulizer
- B. Orally
- C. Nasal spray
- D. Metered-dose inhaler
- E. Subcutaneous injection
Correct Answer: A,B,C,D
Rationale: Cromolyn may be administered via a nebulizer, as an aerosol metered spray, as a nasal spray, or orally. It is not given subcutaneously.