1. The client with seasonal allergic rhinitis is prescribed fluticasone (Flonase), an intranasal
glucocorticosteroid. Which intervention should the nurse imple- ment first?
Answer
Assess the nares for excoriation or bleeding
2. 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?
Answer
I will hold the medication in my mouth for 10 seconds
3. fluticasone action
- how to d/c
- what kind of subtances
- increase production of
- decreased activation of
Answer
- most potent natural antiinflammatory substance
- dampen activation of the inflammatory cells
- increase production of antiinflammatory mediators
- SHOULD NOT BE ABRUPTLY D/Cd
4. fluticasone RN implications
- when to contact provider
- what happens during prolonged therapy
Answer
- 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
5. fluticasone RN implication
- when to administer when taking w/ a bronchodilator [albuterol]
- when to notify HCP
Answer
- use bronchodilator first, allow 5 min to elapse before administering corticosteroids
- notify HCP if sore throat or moth
-
6. Albutero class
Answer
- beta 2 agonist
7. albuterol asthma attack
Answer
- used during attacks because of fast action
8. Which intervention should the nurse implement for the client experiencing bronchospasms?
Answer
administer albuterol (bronchodilator) via a nebulizer
9. The client is prescribed albuterol (Ventolin), a sympathomimetic bron- chodilator, metered-
dose inhaler. Which behavior indicates the teaching con- cerning the inhaler is effective?
Answer
the client exhales and then squeezes the canister as the next inspiration occurs
10. 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?
Answer
administer O2 to maintain O2 sat above 95%
11. albuterol class and action
Answer
class
- beta adrenergic agonist action
- bronchodilation by producing cAMP
12. albuterol RN implications
- VS
- lung.... and secretions....
- what if the pt has CV disease?
Answer
- BP, RR, HR
- lung sounds and character of secretions
- pts w/ Cardiovascular problems should be monitors for ECG changes and chest pain
13. 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?
Answer
- 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
14. 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.
Answer
4 client going to rehanb should not require an IV
15. 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?
Answer
serum glucose
16. 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.
Answer
2
17. 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?
Answer
flush the saline lock
administer the diluted med flush saline lock
18. The nurse is caring for a client newly diagnosed with immunohemolytic anemia. Which
medication should the nurse anticipate the HCP ordering?
Answer
- methylprednisolone (steroids)
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