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”
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Avoid elevated altitudes of greater than 2,000 feet (if possible) and air travel for 2-4 weeks (depending on the oncologist’s advice):
Altitude and air travel restrictions are not common recommendations after completing chemotherapy.
B. Avoid foods high in purine for 30-90 days (depending on the oncologist’s advice):
Restrictions on foods high in purine are not typically associated with post-chemotherapy care.
C. Avoid sun exposure for 60-90 days following chemotherapy (depending on oncologist’s advice):
Chemotherapy can make the skin more sensitive to sunlight. Advising the patient to avoid sun exposure or take precautions such as using sunscreen can help prevent skin damage during this period.
D. Have a solid plan for contraception for 3 months to 2 years (depending on the oncologist’s advice):
Contraception considerations may be important, but the timeframe mentioned is not a standard recommendation following chemotherapy completion. The need for contraception may vary depending on the patient's overall health, reproductive goals, and specific chemotherapy drugs received. This decision is usually discussed with the healthcare provider on an individual basis.
Correct Answer is B
Explanation
A. Shellfish
Shellfish consumption is not typically contraindicated with targeted cancer therapy. However, it is essential for individuals undergoing cancer treatment to follow a well-balanced and nutritious diet. If there are specific dietary restrictions or recommendations based on an individual's overall health or treatment plan, these should be discussed with the healthcare provider or a registered dietitian.
B. Grapefruit
Grapefruit and grapefruit juice contain compounds that can interfere with the metabolism of certain medications, including many targeted therapies. This can result in either increased or decreased levels of the drug in the bloodstream, potentially affecting the efficacy and safety of the treatment. Therefore, individuals receiving targeted therapy are often advised to avoid grapefruit.
C. Yerba mate
Yerba mate is a type of tea made from the leaves of the Ilex paraguariensis plant. While it is generally considered safe, specific interactions with targeted cancer therapies are not well-documented. However, it is always advisable for individuals undergoing cancer treatment to consult with their healthcare team regarding dietary choices, including herbal teas.
D. Aged cheese
Aged cheese is not typically contraindicated with targeted cancer therapy. However, dietary recommendations may vary based on individual health conditions and treatment plans. In some cases, certain dietary restrictions or modifications may be advised, so it's important for individuals to discuss their specific dietary needs with their healthcare providers or dietitians.
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