Nokea
A nurse is teaching a client who is prescribed albuterol about the adverse reactions associated with the drug. Which of the following symptoms, if experienced, should the nurse instruct the client to report to the health care provider?
- A. Fall in blood pressure
- B. Increased nighttime urination
- C. Hearing impairment or deficit
- D. Headache and flushing
Correct Answer: D
Rationale: The nurse should instruct the client to contact the health care provider if palpitations, tachycardia, chest pain, muscle tremors, dizziness, headache, flushing, or difficulty with urination or breathing occurs. Fall in blood pressure, increased nighttime urination, and hearing impairment are not adverse effects associated with a sympathomimetic bronchodilator.
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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.
Before administering a prescribed bronchodilator to a client experiencing acute breathing distress, which of the following would be appropriate for the nurse to assess? Select all that apply.
- A. Blood pressure
- B. Blood glucose
- C. Pulse
- D. Lung sounds
- E. Respiratory rate
Correct Answer: A,C,D,E
Rationale: Prior to initiation of a bronchodilator during acute breathing distress, the nurse needs to assess vital signs, including blood pressure, pulse, and respiratory rate and lung sounds.
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.
The nurse is reviewing the history of a client who is prescribed a long-acting beta-2 agonist. Which of the following would alert the nurse to the need to administer this drug cautiously to the client? Select all that apply.
- A. Hyperlipidemia
- B. Hypertension
- C. Glaucoma
- D. Hyperthyroidism
- E. Diabetes
Correct Answer: B,C,D,E
Rationale: Long-acting beta-2 agonists should be used cautiously in clients with hypertension, cardiac dysfunction, hyperthyroidism, glaucoma, diabetes, prostatic hypertrophy, and history of seizures.
A group of nursing students are reviewing information about mast cell stabilizers. The students demonstrate understanding of the information when they identify which of the following as an example?
- A. Beclomethasone
- B. Cromolyn
- C. Albuterol
- D. Montelukast
Correct Answer: B
Rationale: Cromolyn is an example of a mast cell stabilizer. Beclomethasone is an inhaled corticosteroid. Albuterol is a short-acting beta-2 agonist. Montelukast is an example of a leukotriene modifier.