The client with seasonal allergic rhinitis is prescribed fluticasone (Flonase), an intranasal glucocorticosteroid. Which intervention should the nurse implement first? Assess the nares for excoriation or bleeding
The nurse on a medical unit is providing discharge instructions to a client who is pr...
NUR 325 Quiz I Questions and Correct
Answers
The client with seasonal allergic rhinitis is prescribed fluticasone (Flonase), an
intranasal glucocorticosteroid. Which intervention should the nurse implement first?
✅Assess the nares for excoriation or bleeding
The nurse on a medical unit is providing discharge instructions to a client who is
prescribed fluticasone (aerobid), a glucocorticoid, and a metered-dose inhaler. Which
statement by the client would warrant intervention? ✅I will hold the medication in my
mouth for 10 seconds
Fluticasone action
- how to d/c
- what kind of subtances
- increase production of
- decreased activation of ✅- most potent natural antiinflammatory substance
- dampen activation of the inflammatory cells
- increase production of antiinflammatory mediators
- SHOULD NOT BE ABRUPTLY D/Cd
Fluticasone RN implications
- when to contact provider
- what happens during prolonged therapy ✅- resp status and lung sounds
- assess for s/sx of adrenal insuficciency (anorexia, nausea, weakness, fatigue,
hypotension, hypoglycemia) - if these s/sx appear contact HCP IMMEDIATELY
- withdrawal symptoms
- may caused decrease bone mineral density during prolonged therapy
- adrenal function tests
- increase in serum and urine glucose
Fluticasone RN implication
- when to administer when taking w/ a bronchodilator [albuterol]
- when to notify HCP ✅- use bronchodilator first, allow 5 min to elapse before
administering corticosteroids
- notify HCP if sore throat or moth
-
Albutero class ✅- beta 2 agonist
Albuterol asthma attack ✅- used during attacks because of fast action
,Which intervention should the nurse implement for the client experiencing
bronchospasms? ✅administer albuterol (bronchodilator) via a nebulizer
The client is prescribed albuterol (Ventolin), a sympathomimetic bronchodilator,
metered-dose inhaler. Which behavior indicates the teaching concerning the inhaler is
effective? ✅the client exhales and then squeezes the canister as the next inspiration
occurs
The 6-year-old child is experiencing an acute exacerbation of reactive airway disease.
The child passed out, and the parents brought the child to the emergency depart- ment.
Which intervention should the nurse implement first? ✅administer O2 to maintain O2
sat above 95%
Albuterol class and action ✅class
- beta adrenergic agonist
Action
- bronchodilation by producing camp
Albuterol RN implications
- VS
- lung.... And secretions....
- what if the pt has CV disease? ✅- BP, RR, HR
- lung sounds and character of secretions
- pts w/ Cardiovascular problems should be monitors for ECG changes and chest pain
Pt family teaching for albuterol
- what to encourage
- what to avoid, why?
- what env things to avoid
- how long to allow between albuterol and other meds? ✅- encourage light (2000
ml/day)
- avoid OTC cough, cold, breathing preapartion --> can increase side effects of
arrhythmia
- avoid smoking and other irritants
- use bronchodilator (Albuterol) first and allow 5 mins to elapse before adminitering
other meds
The 24-year-old client diagnosed with a traumatic brain injury is being transferred to a
rehabilitation unit. Which healthcare provider order should the nurse question?
1. Physical therapy to work on lower extremity strength daily.
2. Occupational therapy to work on cognitive functioning bid.
3. A soft diet with mechanical ground meats and thickening agent in fluids.
4. Methylprednisolone (Solu-Medrol), a steroid, IVP q 6 hours. ✅4
Client going to rehanb should not require an IV
, A client is receiving methylprednisolone (Solu-Medrol) 40 mg IV daily. The nurse
anticipates an increase in which laboratory value as the result of this medication?
✅serum glucose
The client with a head injury is admitted into the intensive care unit (ICU). Which health-
care provider medication order would the ICU nurse question?
1. Osmitrol (Mannitol), an osmotic diuretic.
2. Methylprednisolone (Solu-Medrol), a corticosteroid.
3. Phenytoin (Dilantin), an anticonvulsant.
4. Oxygen, 6 L via nasal cannula. ✅2
The nurse is administering methylprednisolone sodium succinate (Solu-Medrol), a
glucocorticoid, intravenous push to a client diagnosed with pericarditis. The client has a
saline lock in the left forearm. After the nurse reconstitutes the powdered medication in
the Act-O-Vial, which intervention should the nurse implement? ✅flush the saline lock
Administer the diluted med
Flush saline lock
The nurse is caring for a client newly diagnosed with immunohemolytic anemia. Which
medication should the nurse anticipate the HCP ordering? ✅methylprednisolone
(steroids)
The client diagnosed with chronic obstructive pulmonary disease is prescribed
methylprednisolone (Solu-Medrol), a glucocorticoid, IVP. Which laboratory data would
warrant immediate intervention by the nurse? ✅WBC count of 15 K (steroids mask
infections)
Methylprednisolone RN implications
- s/sx of adrenal insuficiency
- periods of stress require
- what to avoid (drink) ✅s/sx of adrenal insufficiency (hypotension, weight loss,
weakness, n/v, anorexia, lethargy, confusion, restlessness)
- periods of stress may require more steroids
- avoid grapefruit juice w/ therapy
Methylprednisolone pt teaching
- how not to stop
- what to avoud
- can mask s/sx of
- what to carry
- what kind of tests and exams? ✅- do not stop meds suddenly
- avoid grapefruit juic
- can mask symptoms of infection (avoid sick and report infection immediately)
- carry ID
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