A nurse is teaching a client who has asthma and a prescription for an inhaler. Which of the following instructions should the nurse include?

"Clean the canister and cap of the inhaler every 2 weeks."

"Wait 1 minute between puffs of the inhaler."

"Tilt your head forward and inhale rapidly while depressing the canister."

"Place your middle finger at the mouthpiece and your thumb at the top of the inhaler."

Answer and Explanation

The Correct Answer is B

A) "Clean the canister and cap of the inhaler every 2 weeks": While it's important to keep the inhaler clean, it should be cleaned more frequently than every 2 weeks. Typically, cleaning is recommended at least once a week to prevent medication buildup and ensure proper functioning.

B) "Wait 1 minute between puffs of the inhaler": Waiting 1 minute between puffs allows the medication from the first puff to take effect and opens the airways, making the second puff more effective. This practice helps maximize the medication's absorption and effectiveness.

C) "Tilt your head forward and inhale rapidly while depressing the canister": The correct technique involves tilting the head slightly back, not forward, to open the airways better. Additionally, the client should inhale slowly and deeply, rather than rapidly, to ensure the medication is properly delivered to the lungs.

D) "Place your middle finger at the mouthpiece and your thumb at the top of the inhaler": This description of finger placement is incorrect. The correct technique is to place the thumb at the base of the inhaler and the index and middle fingers on the top of the canister to allow for proper grip and activation of the inhaler.

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Correct Answer is D

Explanation

A) Contact dermatitis: This condition results from an allergic reaction or irritation caused by contact with a substance, such as chemicals, detergents, or allergens. It is not a communicable skin infection and does not spread from person to person.

B) Actinic keratoses: These are rough, scaly patches on the skin caused by prolonged exposure to ultraviolet (UV) rays. They are considered precancerous lesions and are not contagious. They result from environmental factors rather than person-to-person transmission.

C) Psoriasis: This is a chronic autoimmune condition that leads to the rapid buildup of skin cells, causing scaling on the skin's surface. It is not contagious and does not spread through person-to-person contact. Psoriasis is an inherited condition influenced by immune system triggers.

D) Herpes zoster: Also known as shingles, this condition is caused by the reactivation of the varicella-zoster virus (the same virus that causes chickenpox). While shingles itself is not spread from person to person, the virus can be transmitted from a person with shingles to someone who has never had chickenpox, potentially causing chickenpox in the latter individual. The virus is spread through direct contact with the fluid from the blisters.

A. Decreased magnesium level B. Decreased total calcium level C. Elevated phosphate level D. Elevated sodium level

Correct Answer is D

Explanation

A) Decreased magnesium level: Primary aldosteronism typically affects sodium and potassium balance, but it is less likely to cause significant changes in magnesium levels. Therefore, a decreased magnesium level is not the expected electrolyte imbalance in this condition.

B) Decreased total calcium level: Primary aldosteronism does not primarily affect calcium metabolism. While calcium levels could be influenced indirectly, they are not a primary concern in this disorder. Hence, a decreased total calcium level is not expected.

C) Elevated phosphate level: Phosphate levels are generally not directly influenced by aldosterone. Elevated phosphate levels might be seen in other conditions, but they are not characteristic of primary aldosteronism.

D) Elevated sodium level: Primary aldosteronism leads to excess production of aldosterone, which promotes sodium retention by the kidneys. This retention causes elevated sodium levels, resulting in hypernatremia, and contributes to symptoms like frequent urination due to the body's attempt to excrete excess sodium through increased urine production.

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A nurse is teaching a client who has asthma and a prescription for an inhaler. Which of the following instructions should the nurse include?

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