Exam 76: Drugs for Asthma and Chronic Obstructive Pulmonary Disease

A patient with asthma is admitted to an emergency department with a respiratory rate of 22 breaths per minute,a prolonged expiratory phase,tight wheezes,and an oxygen saturation of 90% on room air. The patient reports using fluticasone [Flovent HFA] 110 mcg twice daily and has used 2 puffs of albuterol [Proventil HFA],90 mcg/puff,every 4 hours for 2 days. The nurse will expect to administer which drug?

What are the results of using glucocorticoid drugs to treat asthma? (Select all that apply.)

A 7-year-old child with asthma uses a daily inhaled glucocorticoid and an albuterol MDI as needed. The provider has added montelukast [Singulair] to the child's regimen. Which statement by the child's parent indicates understanding of this medication?

A patient with severe,chronic COPD uses an inhaled LABA/glucocorticoid but continues to have frequent exacerbations of symptoms. The nurse will contact the provider to discuss:

A patient who uses an inhaled glucocorticoid for chronic asthma calls the nurse to report hoarseness. What will the nurse do?

A patient with stable COPD receives prescriptions for an inhaled glucocorticoid and an inhaled beta₂-adrenergic agonist. Which statement by the patient indicates understanding of this medication regimen?

A patient who takes oral theophylline [Theochron] twice daily for chronic stable asthma develops an infection and will take ciprofloxacin. The nurse will contact the provider to discuss:

A patient with asthma comes to a clinic for treatment of an asthma exacerbation. The patient's medication history lists an inhaled glucocorticoid,montelukast [Singulair],and a SABA as needed via MDI. The nurse assesses the patient and notes a respiratory rate of 18 breaths per minute,a heart rate of 96 beats per minute,and an oxygen saturation of 95%. The nurse auscultates mild expiratory wheezes and equal breath sounds bilaterally. What will the nurse do?

A patient with asthma will be using a metered-dose inhaler (MDI)for delivery of an inhaled medication. The provider has ordered 2 puffs to be given twice daily. It is important for the nurse to teach this patient that:

A patient with persistent,frequent asthma exacerbations asks a nurse about a long-acting beta₂-agonist medication. What will the nurse tell this patient?

A parent asks a nurse about growth suppression resulting from the use of an inhaled glucocorticoid in children. What will the nurse tell the parent?

A child is receiving a combination albuterol/ipratropium [DuoNeb] inhalation treatment. The patient complains of a dry mouth and sore throat. What will the nurse do?

A patient who has been newly diagnosed with asthma is referred to an asthma clinic. The patient reports daily symptoms requiring short-acting beta₂-agonist treatments for relief. The patient has used oral glucocorticoids three times in the past 3 months and reports awakening at night with symptoms about once a week. The patient's forced expiratory volume in 1 second (FEV₁)is 75% of predicted values. The nurse will expect this patient to be started on which regimen?

A young adult woman will begin using an inhaled glucocorticoid to treat asthma. The nurse will teach this patient about the importance of which action?

A nurse and a nursing student are reviewing the care of a 30-kg patient who will receive intravenous aminophylline. Which statement by the student indicates an understanding of the administration of this medication?

A patient with stable COPD is prescribed a bronchodilator medication. Which type of bronchodilator is preferred for this patient?

Which medication should be used for asthma patients as part of step 1 management?

A patient with COPD is prescribed tiotropium [Spiriva]. After the initial dose,the patient reports only mild relief within 30 minutes. What will the nurse tell the patient?

Which drugs are used to treat COPD? (Select all that apply.)

A nurse is teaching a group of nursing students about the different formulations of beta₂-adrenergic agonist medications. Which statement by a student indicates understanding of the teaching?