Nokea
A client who is receiving aminophylline complains of heartburn. Which of the following instructions should the nurse provide the client to help alleviate the condition?
- A. Eat small, frequent meals.
- B. Raise the head of the bed.
- C. Limit fluid intake with meals.
- D. Use strict oral hygiene.
Correct Answer: B
Rationale: When a client receiving aminophylline complains of heartburn, the nurse should instruct the client to remain upright with the head end of the bed raised. Eating small, frequent meals and limiting fluid intake with meals help alleviate the symptoms of nausea, and not of heartburn. Using strict oral hygiene helps prevent infection with Candida albicans seen with corticosteroid therapy.
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The nurse teaches a client receiving an inhaled corticosteroid about the possibility of developing oral thrush. Which of the following would the nurse include in the teaching plan as a way to reduce this risk? Select all that apply.
- A. Need to avoid eating after administration
- B. Performing strict oral hygiene
- C. Cleaning the inhaler per package instructions
- D. Using proper technique when administering dose
- E. Administering a dose only every other day
Correct Answer: B,C,D
Rationale: To decrease the likelihood of developing oral thrush, a client should use strict oral hygiene, cleanse the inhaler as directed in the package instructions, and use proper technique when administering a dose. There is no need to avoid eating after administration, and using the drug only every other day would not be effective.
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.
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.
A client receives a loading dose of theophylline to treat acute respiratory symptoms. When assessing the client, the nurse would immediately notify the primary health care provider for which of the following?
- A. Constipation
- B. Abdominal cramps
- C. Bradycardia
- D. Mental depression
Correct Answer: B
Rationale: It is important for the nurse to closely monitor the client for signs of theophylline toxicity. The nurse should notify the primary health care provider immediately if any of the following signs of theophylline toxicity develop: anorexia, nausea, vomiting, diarrhea, confusion, abdominal cramping, headache, restlessness, insomnia, tachycardia, arrhythmias, or seizures. Constipation, bradycardia, and mental depression are not signs of theophylline toxicity.
A client who is experiencing an acute asthmatic attack receives prescribed therapy with a bronchodilator. As part of the plan of care, the nurse would continue to assess which of the following every 4 hours? Select all that apply.
- A. Intake
- B. Blood pressure
- C. Output
- D. Lung sounds
- E. Accessory muscle use
Correct Answer: A,C,D,E
Rationale: The nurse should note the client's respiratory rate, lung sounds, intake, and output and use of accessory muscles in breathing every 4 hours during an acute asthma attack.