Nokea
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.
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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 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 client is receiving theophylline. The nurse checks the client's serum theophylline level and finds it to be less than therapeutic. The nurse reviews the client's medical record, noting that which of the following might be a reason for this? Select all that apply.
- A. Nicotine
- B. Allopurinol
- C. Verapamil
- D. Phenytoin
- E. Ketoconazole
Correct Answer: A,D,E
Rationale: Nicotine, phenytoin (a hydantoin), and ketoconazole can decrease theophylline levels. Verapamil (a calcium channel blocker) and allopurinol can increase theophylline levels.
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.
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.