Nokea
A client is prescribed inhaled corticosteroid therapy along with bronchodilator therapy. Which of the following points should the nurse include in the teaching plan?
- A. Stop corticosteroid therapy immediately if you notice any adverse effects.
- B. Before each dose of corticosteroid, rinse the mouth thoroughly with water.
- C. The corticosteroid drug provides rapid relief during an asthma attack.
- D. Take the corticosteroid several minutes after the bronchodilator dose.
Correct Answer: D
Rationale: The nurse should instruct the client to take the corticosteroid several minutes after the bronchodilator dose. This helps in enhancing the application of the steroid into the bronchial tract. Corticosteroid therapy should never be stopped abruptly. The mouth should be rinsed thoroughly with water after each dose of corticosteroid to prevent the occurrence of fungal infections. The steroid drug does not provide rapid relief during an asthma attack, as it does not dilate the bronchus.
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A client is prescribed an inhaled corticosteroid. The nurse would instruct the client about which of the following as a possible adverse reaction? Select all that apply.
- A. Fungal infection
- B. Pharyngeal irritation
- C. Blurred vision
- D. Bradycardia
- E. Insomnia
Correct Answer: A,B
Rationale: Adverse reactions of inhaled corticosteroids include oral, laryngeal, and pharyngeal irritation and fungal infection. Blurred vision, bradycardia, and insomnia are not associated with inhaled corticosteroids.
A nurse is developing a teaching plan for a client who is to use a dry powder inhaler. Which of the following would the nurse include in the teaching plan? Select all that apply.
- A. Place device in water to clean.
- B. Swallow capsules provided.
- C. Hold inhaler 1 to 2 inches from mouth.
- D. Hold breath for 10 seconds.
- E. Inhale quickly.
Correct Answer: D,E
Rationale: To properly use a dry powder inhaler, the client should do the following: prepare the medication for inhalation, place the mouthpiece close to the lips, inhale quickly, hold breath for 10 seconds, not swallow capsules provided, and not place the inhaler in water.
The nurse instructs a client with asthma to always carry a rescue inhaler or quick-relief medication with him at all times. Which of the following would the client most likely carry? Select all that apply.
- A. Salmeterol (Serevent)
- B. Metaproterenol (Alupent)
- C. Tiotropium (Spiriva)
- D. Albuterol (Proventil)
- E. Formoterol (Foradil)
Correct Answer: B,D
Rationale: Short-acting beta agonists (SABAs) such as metaproterenol and albuterol are used as rescue treatment for asthma. Salmeterol and formoterol are long-acting beta agonists (LABAs). Tiotropium is a cholinergic blocking drug used to treat bronchospasm associated with COPD.
A client with chronic asthma comes to the clinic for a follow-up visit. A nurse should question the client about which of the following? Select all that apply.
- A. Allergies
- B. Frequency of attacks
- C. Severity of attacks
- D. Antiasthma drugs currently being taken
- E. Antiasthma drugs taken in the past
Correct Answer: A,B,C,D,E
Rationale: In clients with chronic asthma, the nurse questions the client concerning allergies, frequency and severity of attacks, factors that cause or relieve attacks, and any antiasthma drugs used currently or taken previously.
A group of nursing students are reviewing information about leukotriene modifiers. The students demonstrate understanding of this class of drugs when they identify that these drugs are given by which route?
- A. Nebulization
- B. Metered-dose inhaler
- C. Nasal spray
- D. Orally
Correct Answer: D
Rationale: Leukotriene modifiers are only administered orally.