Nokea
The nurse teaches a client receiving an inhaled corticosteroid about the possibility of developing oral thrush. Which of the following would the nurse include in the teaching plan as a way to reduce this risk? Select all that apply.
- A. Need to avoid eating after administration
- B. Performing strict oral hygiene
- C. Cleaning the inhaler per package instructions
- D. Using proper technique when administering dose
- E. Administering a dose only every other day
Correct Answer: B,C,D
Rationale: To decrease the likelihood of developing oral thrush, a client should use strict oral hygiene, cleanse the inhaler as directed in the package instructions, and use proper technique when administering a dose. There is no need to avoid eating after administration, and using the drug only every other day would not be effective.
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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 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.
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 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 pediatric client is prescribed cromolyn. The nurse understands that this drug can be administered in which manner? Select all that apply.
- A. Via a nebulizer
- B. Orally
- C. Nasal spray
- D. Metered-dose inhaler
- E. Subcutaneous injection
Correct Answer: A,B,C,D
Rationale: Cromolyn may be administered via a nebulizer, as an aerosol metered spray, as a nasal spray, or orally. It is not given subcutaneously.