A 10 year old child is brought to a respiratory clinic and is prescribed Atrovent (Ipratropium Bromide). Prior to administering the medication, what would the nurse assess for?
Breath sounds
Cardiac disorders
Recent injuries
Hypertension
The Correct Answer is A
A) Breath sounds: Prior to administering Atrovent (Ipratropium Bromide), it is essential for the nurse to assess the child’s breath sounds. Ipratropium is an anticholinergic medication used to relieve bronchospasm in conditions like asthma or chronic obstructive pulmonary disease (COPD). By evaluating breath sounds, the nurse can assess the severity of the respiratory condition and monitor for any wheezing or crackles, which may indicate the need for further intervention or adjustment of the treatment.
B) Cardiac disorders: While some caution may be warranted in patients with cardiac disorders when using certain medications (e.g., sympathomimetics), Ipratropium Bromide is an anticholinergic agent that primarily affects the respiratory system. It is not directly contraindicated in children with cardiac disorders, so assessing for cardiac conditions is not the most critical initial assessment when administering this drug.
C) Recent injuries: Recent injuries do not specifically relate to the need for assessment prior to administering Ipratropium. This medication targets the lungs and airways, so assessing for recent injuries would not be as pertinent unless the injuries impacted the child’s ability to breathe (e.g., rib fractures, lung trauma).
D) Hypertension: Hypertension is not a primary concern when administering Ipratropium Bromide. While anticholinergic drugs should be used cautiously in certain individuals (e.g., those with glaucoma or urinary retention), hypertension is not a contraindication for this medication. It would be more critical to assess for respiratory status, particularly breath sounds, to evaluate the efficacy of the treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Increased intraocular pressure: Sympathomimetic drugs stimulate the sympathetic nervous system and promote "fight or flight" responses, often resulting in vasoconstriction and other effects. Some sympathomimetics, especially those that affect alpha-adrenergic receptors, can lead to increased intraocular pressure, which is a concern in conditions like glaucoma.
B) Decreased blood pressure: Sympathomimetic drugs generally increase blood pressure by stimulating alpha and beta receptors that cause vasoconstriction and increased heart rate. In contrast, drugs that would decrease blood pressure are usually parasympathomimetics or other agents designed to block sympathetic responses.
C) Decreased heart rate: Sympathomimetic drugs typically increase heart rate by stimulating beta-1 adrenergic receptors in the heart. These drugs are used in situations requiring increased cardiac output or to counteract bradycardia. Decreased heart rate would typically occur with parasympathomimetic drugs or medications that block sympathetic activity (e.g., beta blockers).
D) Increased respiration: Sympathomimetic drugs can increase respiratory rate by promoting bronchodilation through beta-2 adrenergic receptor activation in the lungs. However, "increased respiration" as a general effect is not as specific or consistent as the other cardiovascular and ocular effects of these drugs. The primary and most prominent physiological change would be related to the cardiovascular effects.
Correct Answer is D
Explanation
A) Increase in mental acuity: Beta-adrenergic blockers (beta-blockers) do not directly affect mental acuity. In fact, some beta-blockers may cause side effects like fatigue or drowsiness, which can affect mental sharpness. Beta-blockers primarily focus on cardiovascular effects, not cognitive function, making this an unlikely therapeutic goal for their use.
B) Slowing of gastrointestinal motility: Beta-blockers can reduce sympathetic nervous system activity, which may indirectly affect the gastrointestinal system. However, slowing gastrointestinal motility is not a primary therapeutic goal of beta-blocker therapy. The main action of beta-blockers is in the cardiovascular system, not in regulating GI function.
C) Decreased production in gastric acid: Beta-blockers do not significantly reduce gastric acid production. Medications such as proton pump inhibitors or H2 blockers are typically used for managing gastric acid production or reflux. Beta-blockers focus on reducing the workload of the heart and controlling blood pressure, not on acid secretion.
D) Reduction in the heart rate and blood pressure: The primary therapeutic effect of beta-blockers is the reduction of heart rate (negative chronotropic effect) and blood pressure (due to reduced cardiac output and inhibition of the sympathetic nervous system). This is especially beneficial for managing conditions like hypertension, heart failure, and arrhythmias. It is the most likely goal of beta-blocker therapy prescribed by the provider.
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