A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?
Rinses the mouth after each use.
Stores the medication at room temperature.
Attaches a spacer device to the inhaler.
Primes the inhaler with 7 pumps.
The Correct Answer is D
Choice A reason:
Rinsing the mouth after each use of an inhaler is a recommended practice, especially for inhalers containing corticosteroids, to prevent oral thrush and other side effects. Although ipratropium is not a corticosteroid, rinsing the mouth can still help reduce any potential irritation or unpleasant taste.
Choice B reason:
Storing the medication at room temperature is appropriate for most inhalers, including ipratropium2. This ensures the medication remains effective and safe to use. It is important to keep the inhaler away from extreme temperatures and direct sunlight.
Choice C reason:
Attaching a spacer device to the inhaler can be beneficial, especially for patients who have difficulty coordinating the timing of inhalation with the activation of the inhaler. A spacer helps ensure that more medication reaches the lungs rather than being deposited in the mouth or throat.
Choice D reason:
Priming the inhaler with 7 pumps is excessive. Typically, ipratropium inhalers require priming with only 2 to 4 sprays before the first use or if the inhaler has not been used for a few days. Over-priming can waste medication and may indicate that the client needs additional instruction on proper inhaler use.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Suggesting the use of an antacid two hours after taking risedronate is not the best initial response. While antacids can help with heartburn, they can also interfere with the absorption of risedronate if taken too close to the medication. It is more important to first understand how the client is taking the medication to ensure proper administration.
Choice B reason: Reminding the client to take the medication with plenty of water is good advice, as risedronate should be taken with a full glass of water to prevent esophageal irritation. However, this response does not address the immediate concern of increasing heartburn. Understanding the client’s current administration method is crucial.
Choice C reason: Asking the client to describe how she takes the medication is the most appropriate response. This allows the nurse to identify any potential issues with the administration technique, such as not taking the medication with enough water or not remaining upright for at least 30 minutes after taking it. Correcting these issues can help reduce heartburn and improve the medication’s effectiveness.
Choice D reason: Advising the client to go to the nearest emergency department is not necessary unless the heartburn is severe or accompanied by other symptoms such as chest pain or difficulty swallowing. Initially, it is more appropriate to assess the client’s administration technique and provide guidance on proper medication use.
Correct Answer is A
Explanation
Choice A Reason:
Use a straw to ingest: Ferrous sulfate elixir can cause staining of the teeth. Using a straw helps to minimize contact with the teeth, thereby reducing the risk of staining. This method ensures that the medication is ingested directly into the throat, bypassing the teeth.
Choice B Reason:
Swallow undiluted: Swallowing ferrous sulfate elixir undiluted is not recommended because it can cause gastrointestinal irritation. Diluting the elixir in water or juice can help to minimize this irritation and improve absorption.
Choice C Reason:
Mix with an antacid: Mixing ferrous sulfate with an antacid is not advisable because antacids can interfere with the absorption of iron. Iron is best absorbed in an acidic environment, and antacids neutralize stomach acid, thereby reducing iron absorption.
Choice D Reason:
Take with a glass of milk: Taking ferrous sulfate with milk is not recommended because calcium in milk can inhibit the absorption of iron. It is best to take iron supplements on an empty stomach or with a source of vitamin C, such as orange juice, to enhance absorption
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