A nurse is teaching a guardian of a school-age child who has a new prescription for a fluticasone metered-dose inhaler.
Which of the following information should the nurse include in the teaching? (Select all that apply)
Rinse your child’s mouth following administration.
A spacer will make it easier to use the device.
Soak the inhaler in water after use.
Have your child take one inhalation as needed for shortness of breath.
Shake the device prior to administration.
Correct Answer : A,B
Fluticasone is an inhaled steroid that prevents the symptoms of asthma by decreasing inflammation in the airways. It is not used to treat a sudden asthma attack.
Some additional information to explain why the other choices are wrong are:
Choice C is wrong because soaking the inhaler in water after use can damage the device and affect its performance.
Choice D is wrong because fluticasone is not a rescue inhaler that can be used as needed for shortness of breath. It is a controller inhaler that should be used regularly as prescribed by the doctor.
Choice E is wrong because shaking the device prior to administration is not necessary for a fluticasone metered-dose inhaler (MDI). However, it is recommended for fluticasone inhalation powder (Flovent Diskus). Some normal ranges that may be applicable are:
The usual dose of fluticasone MDI for adults and children 12 years and older is 55 to 232 mcg twice a day. The usual dose of fluticasone MDI for children 4 to 11 years old is 30 mcg twice a day. The maximum dose of fluticasone MDI for adults and children 12 years and older is 1000 mcg twice a day.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Hyponatremia is a condition where the sodium level in the blood is too low, which can cause confusion, lethargy, seizures, and coma. A hypertonic solution is a fluid that has a higher concentration of solutes than the blood, which can help raise the sodium level and reduce the brain swelling caused by hyponatremia. Therefore, improved cognition indicates that the treatment is effective.
Choice B. Cardiac arrhythmias absent.
Cardiac arrhythmias are not a common symptom of hyponatremia unless it is severe or rapid in onset.
Therefore, their absence does not necessarily indicate that the treatment is effective.
Choice C. Decreased vomiting.
Vomiting can be a cause or a consequence of hyponatremia, depending on the underlying condition.
Decreased vomiting may indicate that the patient is less nauseated, but it does not reflect the sodium level or the brain status.
Choice D. Absent Chvostek’s sign.
Chvostek’s sign is a facial twitching that occurs when tapping on the cheek, which indicates hypocalcemia (low calcium level).
It is not related to hyponatremia or hypertonic solution.
Normal ranges for sodium are 135 to 145 mEq/L and for calcium are 8.5 to 10.5 mg/dL.
Correct Answer is B
Explanation
Choice A rationale:
The air bubble should not be expelled from the syringe before administering enoxaparin. The air bubble is included to ensure that the entire dose is administered and to help prevent leakage of the medication into the subcutaneous tissue, which can reduce bruising.
Choice B rationale:
After administering enoxaparin, applying firm pressure (but not massaging) to the injection site helps minimize bruising and bleeding. It's important not to massage the site as this can increase the risk of bleeding.
Choice C rationale:
The needle should be inserted fully into the subcutaneous tissue at a 90-degree angle (or at a 45-degree angle if the client has little subcutaneous tissue). Inserting the needle halfway may result in improper administration.
Choice D rationale:
Enoxaparin is a low-molecular-weight heparin that should be administered subcutaneously, not intramuscularly. Administering it intramuscularly could increase the risk of bleeding and is not the appropriate route for this medication.
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