What should the nurse explain to the parent of a child with exercise-induced asthma about when to inhale Cromolyn?
Before exercise to prevent attacks.
At the initial onset of the attack.
During the attack to relieve symptoms.
As often as 4 times a day.
The Correct Answer is A
Choice A rationale
Cromolyn is a mast cell stabilizer that works by inhibiting the release of inflammatory mediators (e.g., histamine, leukotrienes) from mast cells. Its mechanism of action is prophylactic, meaning it prevents the cellular cascade leading to bronchospasm when administered before exposure to a trigger, such as exercise. It has no bronchodilatory effect.
Choice B rationale
Administering cromolyn at the initial onset of an attack is ineffective because it does not have acute bronchodilatory properties. Once the inflammatory cascade is initiated and bronchoconstriction has begun, cromolyn cannot reverse the symptoms. Rescue inhalers like albuterol are needed for acute symptom relief.
Choice C rationale
Cromolyn is a prophylactic medication and does not provide symptomatic relief during an acute asthma attack. Its role is to stabilize mast cells to prevent the release of inflammatory mediators that cause bronchoconstriction and inflammation. Therefore, it is not used to alleviate symptoms once an attack is in progress.
Choice D rationale
While cromolyn can be prescribed for regular daily use, the specific instruction for exercise-induced asthma is to take it before exercise. Taking it as often as 4 times a day without considering the timing relative to triggers may not be optimal for preventing exercise-induced symptoms, as its effect is primarily preventive.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
A peak flow meter measures the maximum speed of exhalation, providing information about airflow obstruction and lung function. While useful for monitoring asthma control, it does not address the patient's difficulty coordinating MDI activation with breathing. It's a diagnostic tool, not a coordination aid.
Choice B rationale
A spacer device is a valved holding chamber that attaches to the MDI. It simplifies inhalation by holding the aerosolized medication, allowing the patient to inhale it slowly and deeply without requiring precise coordination between activation and inspiration. This significantly improves drug delivery to the lungs.
Choice C rationale
Notifying the prescriber that the patient is unable to use the MDI without suggesting solutions is premature. The nurse should first attempt an intervention to resolve the coordination issue, such as suggesting a spacer, as this is a common problem with a well-established solution.
Choice D rationale
While some respiratory medications can be given orally, switching the route of administration should not be the initial intervention for MDI coordination issues. Oral administration can have different pharmacokinetic profiles, systemic side effects, and may not provide the same targeted drug delivery to the airways as inhaled therapy.
Correct Answer is C
Explanation
Choice A rationale
While understanding the spouse's fear is important for a holistic approach, it does not directly address the underlying knowledge deficit or provide a solution to mitigate the perceived risk. The fear likely stems from a lack of understanding regarding transmission and protective measures for tuberculosis, which requires specific education to overcome.
Choice B rationale
Informing the spouse that precautions protect other clients is true but does not alleviate the spouse's personal fear of contracting the disease. The spouse's primary concern is self-preservation and protecting themselves from potential infection, which needs to be directly addressed by demonstrating safety protocols.
Choice C rationale
This action directly empowers the spouse by providing concrete education and demonstration of proper isolation techniques. Understanding and practicing these precautions, such as donning and doffing personal protective equipment and hand hygiene, significantly reduces perceived and actual transmission risk, promoting a sense of safety and control.
Choice D rationale
Stating that the spouse has already been exposed can be misleading and may not be entirely accurate, as exposure does not guarantee infection. Furthermore, it dismisses the spouse's valid anxieties about active disease transmission from a hospitalized individual, potentially fostering mistrust rather than alleviating fear and encouraging visits.
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