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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.
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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.
A nurse is developing a teaching plan about measures to reduce the risk of infection with Candida albicans from antiasthma therapy. The nurse includes this information because the client is prescribed which of the following? Select all that apply.
- A. Albuterol (Ventolin)
- B. Cromolyn (Gastrocrom)
- C. Fluticasone (Flovent)
- D. Tiotropium (Spiriva)
- E. Budesonide/formoterol (Symbicort)
Correct Answer: B,C,E
Rationale: Mast cell aerosols such as cromolyn and inhaled corticosteroids (ICSs) such as fluticasone and budesonide/formoterol have been associated with the development of oral thrush. Therefore, the client needs instructions on how to reduce his risk. Albuterol, a short-acting beta-2 agonist, and tiotropium, a cholinergic blocker, are not associated with the development of thrush.
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.
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 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.