Nokea
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.
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A client who is receiving aminophylline complains of heartburn. Which of the following instructions should the nurse provide the client to help alleviate the condition?
- A. Eat small, frequent meals.
- B. Raise the head of the bed.
- C. Limit fluid intake with meals.
- D. Use strict oral hygiene.
Correct Answer: B
Rationale: When a client receiving aminophylline complains of heartburn, the nurse should instruct the client to remain upright with the head end of the bed raised. Eating small, frequent meals and limiting fluid intake with meals help alleviate the symptoms of nausea, and not of heartburn. Using strict oral hygiene helps prevent infection with Candida albicans seen with corticosteroid therapy.
A client is prescribed zileuton (Zyflo). The nurse instructs the client to contact the primary health care provider if which of the following occur? Select all that apply.
- A. Jaundice
- B. Pruritus
- C. Fatigue
- D. Dizziness
- E. Restlessness
Correct Answer: A,B,C
Rationale: Zileuton may cause liver damage, which may present with the following symptoms: upper right quadrant pain, nausea, fatigue, lethargy, pruritus, and jaundice.
A client who is experiencing an acute asthmatic attack receives prescribed therapy with a bronchodilator. As part of the plan of care, the nurse would continue to assess which of the following every 4 hours? Select all that apply.
- A. Intake
- B. Blood pressure
- C. Output
- D. Lung sounds
- E. Accessory muscle use
Correct Answer: A,C,D,E
Rationale: The nurse should note the client's respiratory rate, lung sounds, intake, and output and use of accessory muscles in breathing every 4 hours during an acute asthma attack.
A client is demonstrating how to use a peak flow meter. The nurse determines that the client is successful when he does which of the following? Select all that apply.
- A. Inhales as forcibly as possible
- B. Stands upright to allow the best inhalation possible
- C. Makes sure indicator is at lowest level on scale
- D. Makes sure lips are sealed tightly around the mouthpiece
- E. Measures peak flow rate at different times each day
Correct Answer: B,C,D
Rationale: When teaching a client to use a peak flow meter, instruct the client to make sure the indicator is at the lowest level, stand upright, make sure the lips form a tight seal around the mouthpiece, exhale as forcibly and as quickly as possible, and test peak flow at the same time each day.
A client is receiving theophylline. The nurse checks the client's serum theophylline level and finds it to be less than therapeutic. The nurse reviews the client's medical record, noting that which of the following might be a reason for this? Select all that apply.
- A. Nicotine
- B. Allopurinol
- C. Verapamil
- D. Phenytoin
- E. Ketoconazole
Correct Answer: A,D,E
Rationale: Nicotine, phenytoin (a hydantoin), and ketoconazole can decrease theophylline levels. Verapamil (a calcium channel blocker) and allopurinol can increase theophylline levels.