Nokea
A patient will be receiving oral theophylline, 600 mg/day, in three divided doses. Identify how many milligrams the patient will receive per dose.
Correct Answer: 200 mg
Rationale: 600 mg/day divided by 3 doses per day = 200 mg/dose.
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A patient is in an urgent care center with an acute asthma attack. The nurse expects that which medication will be used for initial treatment?
- A. An anticholinergic such as ipratropium
- B. A short-acting beta agonist such as albuterol
- C. A long-acting beta agonist such as salmeterol
- D. A corticosteroid such as fluticasone
Correct Answer: B
Rationale: The short-acting beta agonists are commonly used during the acute phase of an asthmatic attack to reduce airway constriction quickly and to restore airflow to normal levels. The other drugs listed are not appropriate for acute asthma attacks. Anticholinergic drugs and long-acting beta agonists are used to prevent attacks; corticosteroids are used to reduce airway inflammation.
The nurse is reviewing medications for the treatment of asthma. Which drugs are used for quick relief of asthma attacks? (Select all that apply.)
- A. Salmeterol inhaler
- B. Albuterol nebulizer solution
- C. Intravenous systemic corticosteroids
- D. Montelukast
- E. Fluticasone inhaler
Correct Answer: B,C
Rationale: Albuterol (a short-acting beta agonist) and intravenous systemic corticosteroids are used to provide quick relief for asthma. Salmeterol is a long-acting beta agonist that is indicated for maintenance treatment, not acute episodes. Fluticasone is an inhaled corticosteroid; montelukast is a leukotriene receptor antagonist (LTRA). These types of medications are used for asthma prophylaxis.
The prescriber has changed the patient's medication regimen to include the leukotriene receptor antagonist (LTRA) montelukast to treat asthma. The nurse will emphasize which point about this medication?
- A. The proper technique for inhalation must be followed.
- B. The patient needs to keep it close by at all times to treat acute asthma attacks.
- C. It needs to be taken every day on a continuous schedule, even if symptoms improve.
- D. When the asthma symptoms improve, the dosage schedule can be tapered and eventually discontinued.
Correct Answer: C
Rationale: LTRAs are indicated for chronic, not acute, asthma and are to be taken every day on a continuous schedule, even if symptoms improve. These drugs are taken orally.
A patient is taking intravenous aminophylline for a severe exacerbation of chronic obstructive pulmonary disease. The nurse will assess for which therapeutic response?
- A. Increased sputum production
- B. Increased heart rate
- C. Increased respiratory rate
- D. Increased ease of breathing
Correct Answer: D
Rationale: The therapeutic effects of bronchodilating drugs such as xanthine derivatives include increased ease of breathing. The other responses are incorrect.
A patient is taking a xanthine derivative as part of treatment for chronic obstructive pulmonary disease. The nurse will monitor for which adverse effects associated with the use of xanthine derivatives?
- A. Diarrhea
- B. Palpitations
- C. Bradycardia
- D. Drowsiness
Correct Answer: B
Rationale: The common adverse effects of the xanthine derivatives include nausea, vomiting, and anorexia. In addition, gastroesophageal reflux has been observed to occur during sleep in patients taking these drugs. Cardiac adverse effects include sinus tachycardia, extrasystole, palpitations, and ventricular dysrhythmias. Transient increased urination and hyperglycemia are other possible adverse effects.