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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).
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During stable chronic phases of asthma, the nurse should advise the client to monitor which of the following? Select all that apply.
- A. Blood pressure
- B. Wheezing
- C. Respiratory rate
- D. Coughing
- E. Peak flow changes
Correct Answer: B,D,E
Rationale: Clients with chronic stable asthma should monitor for symptoms such as wheezing, coughing, peak flow changes, and things that might be making the asthma worse.
A client is prescribed an inhaled corticosteroid. The nurse would instruct the client about which of the following as a possible adverse reaction? Select all that apply.
- A. Fungal infection
- B. Pharyngeal irritation
- C. Blurred vision
- D. Bradycardia
- E. Insomnia
Correct Answer: A,B
Rationale: Adverse reactions of inhaled corticosteroids include oral, laryngeal, and pharyngeal irritation and fungal infection. Blurred vision, bradycardia, and insomnia are not associated with inhaled corticosteroids.
A client is prescribed inhaled corticosteroid therapy along with bronchodilator therapy. Which of the following points should the nurse include in the teaching plan?
- A. Stop corticosteroid therapy immediately if you notice any adverse effects.
- B. Before each dose of corticosteroid, rinse the mouth thoroughly with water.
- C. The corticosteroid drug provides rapid relief during an asthma attack.
- D. Take the corticosteroid several minutes after the bronchodilator dose.
Correct Answer: D
Rationale: The nurse should instruct the client to take the corticosteroid several minutes after the bronchodilator dose. This helps in enhancing the application of the steroid into the bronchial tract. Corticosteroid therapy should never be stopped abruptly. The mouth should be rinsed thoroughly with water after each dose of corticosteroid to prevent the occurrence of fungal infections. The steroid drug does not provide rapid relief during an asthma attack, as it does not dilate the bronchus.
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 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.