A 6-year-old child with asthma is prescribed albuterol as a rescue inhaler for acute exacerbations. The nurse is educating the parents about the proper use of the inhaler. Which of the following instructions is most important for the nurse to provide?
Use the inhaler as needed during an asthma attack, but avoid overuse
Use the inhaler only when the child has difficulty breathing during physical activity
Use the inhaler every 4 hours as a preventative measure
Limit the use of the inhaler to prevent dependency on the medication
The Correct Answer is A
A. Use the inhaler as needed during an asthma attack, but avoid overuse is correct. Albuterol is a short-acting beta-agonist (SABA) used as a rescue inhaler to relieve acute bronchospasm. It should be used during episodes of wheezing, coughing, or shortness of breath, but parents should be instructed not to overuse it, as excessive use can cause tachycardia, tremors, and decreased effectiveness. Monitoring frequency helps identify poorly controlled asthma that may require a review of the maintenance regimen.
B. Use the inhaler only when the child has difficulty breathing during physical activity is partially correct, but limiting it to activity-induced symptoms alone ignores other potential triggers, such as allergens or infections, which can also precipitate asthma attacks. Rescue inhalers are intended for all acute exacerbations, not just activity-induced ones.
C. Use the inhaler every 4 hours as a preventative measure is incorrect. Albuterol is not a maintenance or preventive medication; daily scheduled use is not recommended unless prescribed for specific short-term prophylaxis (e.g., before exercise). Long-term control requires inhaled corticosteroids or other controller medications, not a SABA.
D. Limit the use of the inhaler to prevent dependency on the medication is incorrect. Albuterol does not cause drug dependency, but overuse can indicate poor asthma control. The focus should be on appropriate use for symptom relief rather than fear of dependency.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Rhinorrhea, congestion, mild sore throat, and hoarseness is incorrect because these are typical symptoms of a common upper respiratory infection, such as viral pharyngitis or the common cold. Epiglottitis presents much more acutely and severely.
B. Sudden onset of cough, wheezing, rapid breathing, and difficulty swallowing is incorrect because wheezing is more characteristic of lower airway obstruction, such as asthma or bronchiolitis, rather than epiglottitis, which affects the supraglottic area.
C. Difficulty swallowing, drooling, hoarseness, and sitting in a tripod position is correct because epiglottitis is a rapidly progressing, life-threatening inflammation of the epiglottis. Key clinical signs include drooling due to difficulty swallowing, dysphagia, hoarseness or muffled voice, tripod posture to maximize airway patency, high fever, and a toxic appearance.
D. Hoarseness, stridor, and a barking cough is incorrect because these findings are more consistent with croup (laryngotracheobronchitis). Croup usually develops gradually and presents with a barking cough, low-grade fever, and inspiratory stridor, unlike the acute and severe presentation of epiglottitis.
Correct Answer is D
Explanation
A. Administer a dose of oral antibiotics to treat the infection is incorrect because most cases of croup are viral in origin (commonly parainfluenza virus). Antibiotics are not indicated unless there is a secondary bacterial infection.
B. Place the child in a supine position to facilitate airflow to the lungs is incorrect because lying flat may worsen respiratory distress in a child with croup. Upright positioning is preferred to ease breathing.
C. Encourage the child to lie down to conserve energy is incorrect because supine positioning can increase airway obstruction and worsen stridor. Allowing the child to remain upright and calm is safer.
D. Provide a cool mist humidifier or take the child outside into cool night air is correct because cool, moist air helps reduce laryngeal inflammation and edema, which can relieve stridor and improve breathing. This is a first-line, noninvasive intervention to manage mild to moderate croup symptoms while minimizing respiratory distress.
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