The nurse is caring for a client diagnosed with pneumonia. Which medication will the nurse administer for treatment of client's problem of ineffective airway clearance?
dextromethorphan 10 mg PO q 4 r
cromolyn MDI 2 puffs daily
guaifenesin 200 mg PO q 4 hr
methylprednisone 30 mg IV BID
The Correct Answer is C
A. Dextromethorphan 10 mg PO q 4 hr: Dextromethorphan is a cough suppressant, and while it may be useful for controlling a dry, non-productive cough, it is not appropriate for ineffective airway clearance in pneumonia. In fact, suppressing the cough in pneumonia could prevent the patient from clearing mucus from the airways, exacerbating the problem. It is more appropriate for a client who has a dry cough without significant mucus production.
B. Cromolyn MDI 2 puffs daily: Cromolyn is a mast cell stabilizer used for the prevention of asthma and allergy symptoms, and it is not typically used for treating pneumonia or ineffective airway clearance. It works by preventing the release of inflammatory mediators in response to allergens, but it does not address the issue of clearing mucus in the airways during a bacterial infection like pneumonia.
C. Guaifenesin 200 mg PO q 4 hr: Guaifenesin is an expectorant that helps loosen and thin mucus in the airways, making it easier for the client to cough up and clear secretions. This is the most appropriate medication for addressing ineffective airway clearance in a client with pneumonia, as the goal is to facilitate the removal of mucus and improve respiratory function. Guaifenesin does not suppress the cough reflex but instead promotes productive coughing, which is essential for clearing the airways during a respiratory infection like pneumonia.
D. Methylprednisolone 30 mg IV BID: Methylprednisolone is a corticosteroid used to reduce inflammation and control severe allergic or inflammatory conditions. While corticosteroids may be used in certain cases of pneumonia (e.g., in cases of significant inflammation or an underlying condition like COPD), they are not the first-line treatment for ineffective airway clearance. The priority in this case is to promote mucus clearance, which is better addressed by guaifenesin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["20"]
Explanation
Step-by-Step Solution:
Calculate the volume of medication to administer.
The available medication is 125 mg/5 mL.
We need to administer 500 mg.
To find the volume, we can set up a proportion:
125 mg / 5 mL = 500 mg / x mL
Cross-multiplying:
125x = 500 x 5
Solving for x:
x = (500 x 5) / 125 = 20 mL
Correct Answer is A
Explanation
A. Hand washing before and after client contact: The most important infection control guideline when caring for a client with acute respiratory distress syndrome (ARDS) who is on a ventilator is hand hygiene. This is because ventilated patients are at high risk for ventilator-associated pneumonia (VAP) and other infections. Hand washing is the most effective method of preventing the spread of pathogens that could lead to nosocomial infections. The nurse should perform proper hand hygiene both before and after any patient interaction, as this is critical in preventing the transmission of bacteria or viruses, especially in patients with compromised respiratory systems.
Explanation of each option:
B. Placement of an indwelling urinary catheter using sterile technique:
While using sterile technique when placing an indwelling urinary catheter is essential to prevent urinary tract infections (UTIs), it is not the top priority for infection control in this situation. The primary concern for infection in ARDS patients who are on mechanical ventilation is preventing respiratory infections, particularly ventilator-associated pneumonia (VAP). Although catheter-associated infections should be prevented, the most immediate concern is preventing respiratory-related infections.
C. Initiate neutropenic precautions:
Neutropenic precautions are important for patients who have immunocompromised conditions (such as those undergoing chemotherapy or with bone marrow suppression) to protect them from infections. However, ARDS does not necessarily compromise the immune system in the same way. The priority infection control measure for a patient on a ventilator with ARDS is preventing respiratory infections. Therefore, neutropenic precautions would not be the most relevant or highest priority in this case.
D. Clean technique with central IV line care:
Maintaining clean technique with central intravenous (IV) line care is important to prevent infections, such as central line-associated bloodstream infections (CLABSI). However, the most critical infection control measure for a patient on a ventilator with ARDS is still to focus on preventing respiratory infections, particularly ventilator-associated pneumonia (VAP). While IV line care is important, it is secondary to preventing respiratory tract infections in this scenario.
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