A patient admitted to the medical-surgical floor has a history of end-stage COPD. The patient was admitted with the diagnosis of “Exacerbation of COPD”.

Which prescription would the RN not question as it relates to this patient’s treatment regimen?

“02 @ 2L NC and titrate to keep SPO2 approximately 88-92%”

“Prednisone 20 mg PO daily for one year”

“Albuterol nebulizer treatment q 1 hour prn respiratory distress”

“Cromolyn 20 mg inhaled via nebulization QID”

Answer and Explanation

The Correct Answer is C

A. "O2 @ 2L NC and titrate to keep SPO2 approximately 88-92%"

While oxygen therapy is essential in COPD exacerbation, the specific target range may vary based on the patient's condition and arterial blood gas values. The nurse may need to assess the patient's response and adjust oxygen accordingly.

B. "Prednisone 20 mg PO daily for one year"

Prescribing prednisone at a dose of 20 mg PO daily for one year seems unusual for the treatment of a COPD exacerbation. Steroid therapy is commonly used in exacerbations, but the duration and dose may vary. This prescription may need clarification.

C. "Albuterol nebulizer treatment q 1 hour prn respiratory distress"

This prescription is consistent with the management of an exacerbation of COPD. Albuterol is a short-acting beta-agonist bronchodilator that is commonly used in the treatment of acute respiratory distress in patients with COPD. The "q 1 hour prn respiratory distress" indicates that the medication can be administered every 1 hour as needed for relief of respiratory distress during the exacerbation.

D. "Cromolyn 20 mg inhaled via nebulization QID"

Cromolyn is a mast cell stabilizer and is not typically a first-line medication for the treatment of COPD exacerbation. This prescription may warrant clarification, especially in the context of an acute exacerbation.

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Correct Answer is D

Explanation

A. The inhaled form may cause more side effects than the oral form.

The route of administration does not necessarily determine the likelihood of side effects. Both inhaled and oral forms of albuterol can cause side effects, but they may vary in nature.

B. The inhaled form requires an increased dose.

The dose of albuterol may differ between inhaled and oral forms, but it is not accurate to say that the inhaled form always requires an increased dose. The choice of dosage depends on factors such as the severity of symptoms and the patient's response to treatment.

C. The inhaled form will not lead to increased doses.

The need for increased doses depends on the individual patient's response and the severity of symptoms. In some cases, increased doses may be necessary, especially during acute exacerbations.

D. The inhaled form has a more immediate onset of action.

Inhaled albuterol has a quicker onset of action compared to the oral form. When inhaled, the medication reaches the airways directly, leading to rapid bronchodilation and relief of symptoms. This is especially important during acute bronchoconstriction or asthma exacerbations when prompt relief is needed.

A. Glucocorticoid B. Mast cell stabilizer C. Mucolytic agent D. Short-acting beta 2 agonist

Correct Answer is D

Explanation

A. Glucocorticoid

Glucocorticoids are anti-inflammatory medications commonly used as long-term control medications in asthma management. They are not typically considered rescue inhalers. They work gradually over time to reduce inflammation and are not suitable for immediate relief during an acute asthma attack.

B. Mast cell stabilizer

Mast cell stabilizers are anti-inflammatory medications that work by preventing the release of inflammatory substances from mast cells. They are used as maintenance therapy to prevent asthma symptoms but are not rescue inhalers. They do not provide quick relief during acute episodes.

C. Mucolytic agent

Mucolytic agents are medications that help thin and loosen mucus in the airways. While they may be used to improve respiratory symptoms, they are not considered rescue inhalers. They do not provide rapid bronchodilation and are typically used for different purposes, such as addressing mucus production and clearance.

D. Short-acting beta 2 agonist

This is the correct answer. Short-acting beta 2 agonists (SABAs) are bronchodilators that provide quick relief during acute bronchoconstriction. They act by relaxing the smooth muscles in the airways, allowing for rapid dilation and improved airflow. SABAs are commonly used as rescue inhalers to alleviate symptoms during asthma attacks or sudden exacerbations.

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A patient admitted to the medical-surgical floor has a history of end-stage COPD. The patient was admitted with the diagnosis of “Exacerbation of COPD”. Which prescription would the RN not question as it relates to this patient’s treatment regimen?

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Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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A patient admitted to the medical-surgical floor has a history of end-stage COPD. The patient was admitted with the diagnosis of “Exacerbation of COPD”.

Which prescription would the RN not question as it relates to this patient’s treatment regimen?