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?

A. Maintenance therapy of controlled chronic asthma

Glucocorticoids are commonly used as maintenance therapy for controlled chronic asthma to prevent exacerbations and maintain long-term control.

B. Severe asthmatic attack

While bronchodilators are often the first-line treatment for a severe asthmatic attack, glucocorticoids may be added to reduce inflammation and improve overall outcomes.

C. Asthma that is unresponsive to bronchodilator therapy

In cases where asthma is unresponsive to bronchodilator therapy or there is an exacerbation of asthma symptoms, glucocorticoids (steroids) are often prescribed. These medications have anti-inflammatory effects and can help reduce airway inflammation, improving symptoms and preventing further exacerbation.

D. Acute allergic reaction

Glucocorticoids may be used in the management of acute allergic reactions, but they are not the first-line treatment. Antihistamines and other medications are typically used initially, and glucocorticoids may be added in certain cases.

A. Remove the intravenous catheter.

While removing the intravenous catheter is an important step, the immediate priority in cases of extravasation is to stop the infusion to prevent further leakage into the surrounding tissues. After stopping the infusion, the catheter can be carefully removed.

B. Pack the intravenous site with ice.

Cold compresses or ice packs are sometimes used in the management of certain types of extravasation to help reduce local swelling and vasoconstriction. However, the immediate priority is to stop the infusion (Choice C). After that, specific interventions, such as warm or cold compresses, may be employed based on the specific chemotherapy agent involved.

C. Stop the intravenous infusion.

This is the correct answer. Stopping the infusion is the first and most immediate action to prevent further leakage of the chemotherapy drug into the surrounding tissues, reducing the risk of tissue damage and adverse effects.

D. Attempt to aspirate residual medication from the patient’s vein.

While aspirating residual medication may be part of the overall management of extravasation, it is not the first action. The priority is to stop the infusion to prevent further damage. After stopping the infusion, the nurse may assess the situation and determine whether aspirating residual medication is appropriate.