Nokea
A client is prescribed zileuton (Zyflo). The nurse instructs the client to contact the primary health care provider if which of the following occur? Select all that apply.
- A. Jaundice
- B. Pruritus
- C. Fatigue
- D. Dizziness
- E. Restlessness
Correct Answer: A,B,C
Rationale: Zileuton may cause liver damage, which may present with the following symptoms: upper right quadrant pain, nausea, fatigue, lethargy, pruritus, and jaundice.
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During stable chronic phases of asthma, the nurse should advise the client to monitor which of the following? Select all that apply.
- A. Blood pressure
- B. Wheezing
- C. Respiratory rate
- D. Coughing
- E. Peak flow changes
Correct Answer: B,D,E
Rationale: Clients with chronic stable asthma should monitor for symptoms such as wheezing, coughing, peak flow changes, and things that might be making the asthma worse.
A client is prescribed albuterol for bronchospasm in chronic bronchial asthma. Which of the following nursing diagnoses would the nurse expect to see on the care plan as a result of the adverse reaction of albuterol?
- A. Anxiety
- B. Risk of Impaired Oral Mucous Membranes
- C. Ineffective Tissue Perfusion
- D. Risk of Injury
Correct Answer: A
Rationale: The nurse would most likely identify a nursing diagnosis of Anxiety related to the adverse reaction of albuterol. A nursing diagnosis of Risk of Impaired Mucous Membranes may be seen with the use of corticosteroids, which increase the risk of oral candidiasis. There is no increased risk of injury or ineffective tissue perfusion with the use of albuterol therapy.
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.
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.
Before leaving the hospital after an acute asthma attack, a client is given a prescription for fluticasone/salmeterol (Advair) 250/50 to inhale one puff twice a day. The nurse completing the client's discharge teaching should tell the client which of the following? Select all that apply.
- A. Take the medication as needed.
- B. Continue to carry a rescue inhaler.
- C. Check peak flow daily.
- D. Rinse mouth after each use.
- E. Shake meter well before using.
Correct Answer: B,C,D
Rationale: The drug is a dry powder inhaler that contains an inhaled corticosteroid and a long-acting beta agonist. The medication should be taken every day as per the directions on the label to prevent future exacerbations. The client should continue to carry a rescue inhaler and check peak flow around the same time each day. Advair does not need to be shaken prior to use as it is a dry powder inhaler. The client should be advised to rinse his mouth out after each use to prevent oral thrush.