A woman with a history of asthma comes to the clinic for evaluation for pregnancy. The woman's pregnancy test is positive. When reviewing the woman's medication therapy regimen for asthma, which medication would the nurse identify as problematic for the woman now that she is pregnant?

ipratropium

albuterol

salmeterol

Prednisone

Answer and Explanation

The Correct Answer is C

A. Ipratropium:

Ipratropium is an anticholinergic bronchodilator used to relieve bronchospasm associated with asthma and chronic obstructive pulmonary disease (COPD). It works by relaxing the muscles around the airways to improve breathing. In pregnant women with asthma, ipratropium is generally considered safe for use when the benefits of controlling asthma symptoms outweigh the potential risks to the fetus. It is minimally absorbed systemically, reducing the risk of systemic side effects for both the mother and the fetus.

B. Albuterol:

Albuterol is a short-acting beta agonist (SABA) commonly used as a rescue inhaler for acute asthma symptoms. It works by relaxing the muscles in the airways, making it easier to breathe. Albuterol is considered safe for use during pregnancy, and it is often recommended as needed to relieve bronchospasm in pregnant women with asthma. Controlling asthma symptoms with albuterol can help improve maternal oxygenation and prevent complications associated with poorly controlled asthma during pregnancy.

C. Salmeterol:

Salmeterol is a long-acting beta agonist (LABA) used for the long-term control of asthma symptoms. It works similarly to albuterol but has a longer duration of action. Salmeterol is generally not recommended as the sole therapy for asthma during pregnancy due to limited safety data. While animal studies have shown adverse effects on fetal development, there are no adequate and well-controlled studies in pregnant women. Therefore, the risks versus benefits of using salmeterol during pregnancy should be carefully considered, and alternative treatments may be preferred.

D. Prednisone:

Prednisone is a corticosteroid medication used to reduce inflammation and suppress immune responses in conditions such as asthma. It is often prescribed to manage asthma exacerbations during pregnancy. While corticosteroids are generally considered safe for short-term use during pregnancy to control asthma symptoms, they may have risks associated with long-term or high-dose use, especially if used during the first trimester. Potential risks include fetal growth restriction and cleft palate. However, the benefits of controlling asthma symptoms and preventing exacerbations often outweigh the potential risks of corticosteroid use during pregnancy. Therefore, prednisone may be prescribed judiciously during pregnancy, and the dose should be tailored to the individual's needs while considering potential risks to the fetus.

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Correct Answer is D

Explanation

A. Fatigue - Fatigue is a common side effect of chemotherapy and can significantly impact a patient's quality of life. While it can be debilitating and affect daily activities, it is not typically considered as serious as myelosuppression. Fatigue usually improves over time after completion of chemotherapy treatment.

B. Hair loss - Hair loss, or alopecia, is another common side effect of chemotherapy. It can be distressing for many patients, but it is generally not considered medically serious. Hair typically grows back after the completion of chemotherapy treatment.

C. Vomiting - Nausea and vomiting are common side effects of chemotherapy, known as chemotherapy-induced nausea and vomiting (CINV). While they can cause discomfort and affect a patient's well-being, they are usually manageable with antiemetic medications. In severe cases, dehydration and electrolyte imbalances may occur, but they are generally reversible and not as serious as myelosuppression.

D. Myelosuppression - Myelosuppression, also known as bone marrow suppression, is a serious side effect of chemotherapy. It can lead to a decrease in the production of blood cells (white blood cells, red blood cells, and platelets) by the bone marrow. This can increase the risk of infections, anemia, and bleeding, which can be life-threatening if not managed promptly. Myelosuppression requires close monitoring and may necessitate treatment adjustments or supportive care measures to prevent complications.

A. developing most often in women in their 30s B. feeling a strong need to void C. passing a large amount of urine D. sneezing as an initiating stimulus

Correct Answer is D

Explanation

A. Developing most often in women in their 30s:

Stress incontinence can affect women of various ages, not specifically those in their 30s. While childbirth and hormonal changes associated with aging can increase the risk of stress incontinence, it is not limited to any particular age group.

B. Feeling a strong need to void:

This characteristic is more indicative of urgency incontinence, also known as overactive bladder (OAB), where there is a sudden, strong urge to urinate that is difficult to control. It is different from stress incontinence, which is triggered by physical movements or activities that increase pressure on the bladder.

C. Passing a large amount of urine:

This choice does not specifically describe a characteristic of stress incontinence. Stress incontinence involves the leakage of small amounts of urine during activities such as coughing, sneezing, laughing, or exercising, rather than the passage of a large amount of urine at once.

D. Sneezing as an initiating stimulus:

This is the correct characteristic of stress incontinence. Stress incontinence is characterized by the leakage of urine during physical activities or movements that increase intra-abdominal pressure, such as coughing, sneezing, laughing, lifting, or exercising. Sneezing is a common initiating stimulus for stress incontinence episodes.

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A woman with a history of asthma comes to the clinic for evaluation for pregnancy. The woman's pregnancy test is positive. When reviewing the woman's medication therapy regimen for asthma, which medication would the nurse identify as problematic for the woman now that she is pregnant?

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