Nokea
When educating a patient recently placed on inhaled corticosteroids, the nurse will discuss which potential adverse effects?
- A. Fatigue and depression
- B. Anxiety and palpitations
- C. Headache and rapid heart rate
- D. Oral candidiasis and dry mouth
Correct Answer: D
Rationale: Oral candidiasis and dry mouth are two possible adverse effects of inhaled corticosteroids. The other responses are incorrect.
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After receiving a nebulizer treatment with a beta agonist, the patient states she is feeling slightly nervous and wonders if her asthma is getting worse. What is the nurse's best response?
- A. This is an expected adverse effect. Let me take your pulse.
- B. The next scheduled nebulizer treatment will be skipped.
- C. I will notify the physician about this adverse effect.
- D. We will hold the treatment for 24 hours.
Correct Answer: A
Rationale: Nervousness, tremors, and cardiac stimulation are possible and expected adverse effects of beta agonists. The other options are incorrect responses.
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.
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 has a metered-dose inhaler that contains 200 actuations ('puffs'), and it does not have a dose counter. He is to take two puffs two times a day. If he does not take any extra doses, identify how many days will this inhaler last at the prescribed dose.
Correct Answer: 50 days
Rationale: Assuming that two puffs are taken two times a day, and the inhaler has a capacity of 200 inhalations. Two puffs two times a day equal four inhalations per day. Four divided into 200 yields 50, that is, the inhaler will last approximately 50 days.
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.