Nokea
A client with asthma has been prescribed an antiasthmatic drug. Before administering the drug, the nurse assesses the respiratory rate of the client. The nurse notifies the primary health care provider based on which finding?
- A. 10 breaths/min
- B. 14 breaths/min
- C. 18 breaths/min
- D. 22 breaths/min
Correct Answer: A
Rationale: The nurse should consider 10 breaths/min an abnormal respiratory rate and notify the primary health care provider. Respiratory rates below 12 breaths/min or above 24 breaths/min are considered abnormal. A respiratory rate between 12 breaths/min and 24 breaths/min is considered normal.
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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.
The nurse is reviewing the medication record of a client with asthma and notes that the health care provider has prescribed a monoclonal antibody as part of the treatment plan. The nurse would anticipate administering which drug?
- A. Zafirlukast
- B. Zileuton
- C. Omalizumab
- D. Salmeterol
Correct Answer: C
Rationale: Omalizumab (Xolair) is a monoclonal antibody used in the treatment of asthma. Leukotriene receptor antagonists include montelukast (Singulair) and zafirlukast (Accolate). Zileuton (Zyflo) is classified as a leukotriene formation inhibitor. Salmeterol (Serevent Diskus) is a long-term beta-2 agonist.
A client with exercise-induced bronchospasm calls the physician's office to obtain a refill for his breathing medication. The client would most likely be prescribed which of the following? Select all that apply.
- A. Beclomethasone (Qvar)
- B. Levalbuterol (Xopenex)
- C. Theophylline (Theo-Dur)
- D. Mometasone (Asmanex)
- E. Bitolterol (Tomalate)
Correct Answer: B,E
Rationale: Beta-2 agonists, such as levalbuterol and bitolterol, are used to treat exercise-induced bronchospasm. Beclomethasone and mometasone are inhaled corticosteroids. Theophylline is a xanthine derivative.
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.