NUR 2474 Rasmussen Pharm Exam 2 - (Respiratory, GI,
Cardiac, Lipid Drugs, Anticoagulation) – Qs & As
Patient Education on using inhalers Right Ans - For any patient prescribed
an inhaler, the RN should ensure the client can self-administer the medication.
Teach back needed
The patient should wait 1-2 minutes between puffs
The patient should wait 5 minutes between 2 different inhalers
The patient should take a bronchodilator before a corticosteroid medication
(B before C)
The patient must keep track of doses on their inhaler
If opening a new inhaler, the patient should shake it and test before use.
If dexterity is limited, a spacer can be used to get more medication in the
airway.
If the patient uses a steroid, they must wash their mouth out after use.
If not, fungal infection may occur
The patient should hold breath 10 seconds after receiving a puff.
Short-term asthma treatment Right Ans - Bronchodilator: albuterol
Acts as a rescue inhaler during asthma attacks.
Onset is in 5 minutes and will last longer.
Xanthine Derivatives: theophylline
Dilates airways
Can have high drug interactions in the body
IV/ inhaled glucocorticoids.
Long term asthma treatment Right Ans - Bronchodilator: salmeterol.
Used to control symptoms of asthma
Never is used alone (often with steroid)
Anticholinergics: ipratropium bromide
For long term asthma prevention
Works very slowly.
Corticosteroids: fluticasone
Non bronchodilation
Can take several weeks to show
COPD treatment Right Ans - Bronchodilator- short acting albuterol
Steroid
,Must keep o2 saturation between 88-92%
Most asthma treatments require what? Right Ans - Combination of
medications- most medications cannot be used alone (need bronchodilator
plus steroid)
Rescue inhalers Right Ans - Quickly relax airways.
albuterol, epinephrine, metaproterenol, IV steroid
Long term inhalers Right Ans - salmeterol, ipratropium, theophylline,
montelukast ,fluticasone
Treatment of acute asthma attack Right Ans - Oxygen use
Short acting bronchodilator- albuterol
Corticosteroid- ipratropium bromide IV
Will relieve hypoxemia, reduce airway inflammation, and relieve obstruction.
Bronchodilator mechanism of action Right Ans - mimics the sympathetic
NS and opens up the lungs and stimulates beta receptors
Fast acting vs. long term asthma relief Right Ans - Fast acting: used for
acute asthma relief, Long acting is for chronic asthma management and COPD
AE of bronchodilators Right Ans - tachycardia, angina, tremors, nervous
and shaky feeling, hyperglycemia.
Pt teaching for bronchodilators Right Ans - ensure patient takes
medication as prescribed and does not overuse short acting bronchodilator.
Never use it alone with asthma treatment.
Glucocorticoid mechanism of action Right Ans - works to stop the
inflammatory process in the lungs, preventing bronchoconstriction. Stabilizes
WBC membranes that release bronchial constricting substances, increases
bronchial smooth muscle beta adrenergic stimulation.
Forms of Glucocorticoids Right Ans - Inhaled: used for asthma and is the
most tolerated and fast acting, but can also be IV for systemic effects on the
body.
, AE of glucocorticoids Right Ans - throat and mouth irritation, dry mouth,
oral fungal infections.
Pt teaching for glucocorticoids Right Ans - must teach patients to rinse
mouth out after steroid use to prevent oral fungal infections, take
bronchodilator 5 mins before steroid.
Tiotropium mechanism of action Right Ans - treats maintenance therapy
and bronchospasm in patients with COPD. Will block muscarinic receptors in
lungs
How can we administer tiotropium? Right Ans - inhaler
What should we not use tiotropium for? Right Ans - asthma
Tiotropium onset and therapeutic level timeframes Right Ans - Therapeutic
effects start 30 min post inhalation, peaks in 3 hrs, and lasts 24 hrs. With
consistent dosing, bronchodilation will improve after 8 days.
Anticholinergic side effects Right Ans - blurred vision, dry mouth,
tachycardia, constipation, urinary retention
How can we help aid patient experiencing anticholinergic effects? Right
Ans - give hard candy or fluids to suck on
OTC sympathomimetics and cardiac patients Right Ans -
Sympathomimetics stimulate the immune system and cause vasoconstriction
widespread and interfere with BP. Found in many cold and allergy
medications. Patients with cardiac problems must have caution with use of
these drugs and hypertension treatment.
Treatment principles of cold symptoms in children Right Ans - Must treat
individual symptoms. Many medications used OTC to treat colds are
combination medications.
In children, it can be dangerous if used as a combination medication for a cold.
The parent should treat the symptoms only with individual agents and only
with agents indicated for pediatric use.
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