Nokea
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.
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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.
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.
A client has been admitted to a health care facility with acute bronchospasm. The primary health care provider prescribes the drug epinephrine. The nurse anticipates administering this drug by which route?
- A. Intravenous
- B. Intramuscular
- C. Subcutaneous
- D. Intradermal
Correct Answer: C
Rationale: The nurse should use the subcutaneous route to administer epinephrine for acute bronchospasm. Doses of epinephrine are measured in tenths of a milliliter. A tuberculin syringe is used for measuring and administering these drugs by the parenteral route. The other routes are not appropriate for this situation.
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.
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.