To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client's caregivers?

When using the discus, have the client breathe out rapidly into the mouthpiece.

Offer the discus to the client for use during an acute asthma attack.

Clients using the discus may experience decreased blood pressure.

Explain that the client should not use the discus more than twice daily.

Answer and Explanation

The Correct Answer is D

Choice A reason: This is not a correct instruction for the nurse to provide to the client's caregivers. When using the discus, the client should breathe out slowly and gently away from the mouthpiece, not into it. Breathing out rapidly into the mouthpiece can cause the powder to disperse and reduce the amount of medication delivered to the lungs. The client should also rinse the mouthpiece with water after each use and dry it thoroughly.

Choice B reason: This is not a correct instruction for the nurse to provide to the client's caregivers. The discus is not intended for use during an acute asthma attack, as it does not provide immediate relief of bronchospasm. The discus is a combination of fluticasone, a corticosteroid that reduces inflammation, and salmeterol, a long-acting beta-agonist that relaxes the airway muscles. The discus is a maintenance therapy that should be used regularly to prevent asthma symptoms and exacerbations. The client should also have a rescue inhaler, such as albuterol, for quick relief of asthma attacks.

Choice C reason: This is not a correct instruction for the nurse to provide to the client's caregivers. Clients using the discus may experience increased blood pressure, not decreased, as a possible side effect of salmeterol. Salmeterol can stimulate the beta receptors in the heart and blood vessels, causing tachycardia, palpitations, and hypertension. The nurse should monitor the client's blood pressure and heart rate regularly and report any abnormal findings to the healthcare provider.

Choice D reason: This is the correct instruction for the nurse to provide to the client's caregivers. The discus should not be used more than twice daily, as it can increase the risk of adverse effects and reduce the effectiveness of the medication. The discus should be used once in the morning and once in the evening, about 12 hours apart, to provide optimal control of asthma symptoms. The nurse should teach the client and the caregivers how to use the discus correctly and safely, and to follow the prescribed dosage and schedule.

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Correct Answer is A

Explanation

Choice A reason: Taking levothyroxine on an empty stomach ensures better absorption and prevents interference from food or other medications. The client should take levothyroxine at least 30 minutes before breakfast or four hours after the last meal of the day.

Choice B reason: Consuming foods that are high in iodine is not recommended for clients taking levothyroxine, as it may affect the thyroid function and the dosage of the medication. Foods that are high in iodine include seafood, seaweed, dairy products, and iodized salt.

Choice C reason: Administering levothyroxine at bedtime is not advisable, as it may cause insomnia, anxiety, or palpitations. Levothyroxine is best taken in the morning, as it mimics the natural secretion of thyroid hormones.

Choice D reason: Avoiding the use of iron supplements is not necessary for clients taking levothyroxine, as long as they are taken at different times. Iron supplements can interfere with the absorption of levothyroxine, so they should be taken at least four hours apart.

A. Primes the inhaler with 7 pumps. B. Rinses the mouth after each use. C. Stores the medication at room temperature. D. Attaches spacer device to the inhaler.

Correct Answer is A

Explanation

Choice A reason: Priming the inhaler with 7 pumps is an incorrect action, as it wastes the medication and reduces the number of doses available. The nurse should teach the client that ipratropium inhaler only needs to be primed once when it is first used, or if it has not been used for more than 3 days. To prime the inhaler, the client should spray it into the air away from the face until a fine mist appears.

Choice B reason: Rinsing the mouth after each use is a correct action, as it prevents dry mouth and irritation caused by the medication. Ipratropium is an anticholinergic drug that blocks the action of acetylcholine, a neurotransmitter that stimulates the secretion of saliva and mucus. The nurse should teach the client to rinse the mouth with water or mouthwash after using the inhaler, and to drink plenty of fluids to stay hydrated.

Choice C reason: Storing the medication at room temperature is a correct action, as it preserves the quality and effectiveness of the medication. The nurse should teach the client to store the ipratropium inhaler at room temperature, away from heat, moisture, and direct sunlight. The nurse should also instruct the client to check the expiration date and the dose counter of the inhaler, and to replace it when it is empty or expired.

Choice D reason: Attaching spacer device to the inhaler is a correct action, as it improves the delivery and absorption of the medication. A spacer is a device that attaches to the mouthpiece of the inhaler and creates a chamber that holds the medication until the client inhales it. The nurse should teach the client to use a spacer with the ipratropium inhaler, as it can reduce the risk of side effects, such as coughing, throat irritation, and hoarseness. The nurse should also teach the client how to clean and maintain the spacer device.

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To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client's caregivers?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client receives a new prescription for levothyroxine. Which statement made by the client indicates to the nurse that the education was effective?

Correct Answer is A

Explanation

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?

Correct Answer is A

Explanation

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