Nokea
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.
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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.
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.
After teaching a group of nursing students about xanthine derivatives, the instructor determines that the teaching was successful when the students state which of the following? Select all that apply.
- A. Xanthine derivatives cause flushing.
- B. The action of xanthine derivatives leads to bradycardia.
- C. Xanthine derivatives cause a reduction in airway inflammation.
- D. Xanthine derivatives cause hypoglycemia.
- E. Xanthine derivatives stimulate the CNS to promote bronchodilation.
Correct Answer: A,E
Rationale: Xanthine derivatives can cause flushing, tachycardia, and hyperglycemia. Xanthine derivatives elicit their effects by stimulating the CNS to promote bronchodilation.
A nurse is caring for a client who is receiving cromolyn orally. Which of the following instructions would the nurse include in the client's teaching plan?
- A. Do not take the drug at bedtime.
- B. Swallow the drug without chewing.
- C. Take the drug with food or milk.
- D. Take the drug at least 30 minutes before meals.
Correct Answer: D
Rationale: When administered orally, cromolyn is given 30 minutes before meals and at bedtime. The oral form of the drug comes in an ampule. The ampule is opened and the contents are poured into a glass of water. The nurse stirs the mixture thoroughly. The client must drink all of the mixture. The drug may not be mixed with any other substance (e.g., fruit juice, milk, or foods).
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.