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 ["50"]
Explanation
Step 1: Calculate the total puffs per day. 2 puffs/dose × 2 doses/day = 4 puffs/day.
Step 2: Calculate the number of days the inhaler will last. 200 puffs ÷ 4 puffs/day = 50 days. The inhaler will last 50 days.
Correct Answer is B
Explanation
Choice A rationale
A 30-pack-year smoking history indicates significant cumulative exposure to respiratory irritants, predisposing the client to COPD development. However, this historical factor does not indicate acute respiratory distress requiring immediate intervention. While a strong risk factor, it doesn't present as an emergent physiological alteration demanding first assessment in this scenario. Current physiological stability takes precedence over historical risk.
Choice B rationale
A client in a tripod position utilizing accessory muscles to breathe indicates significant respiratory distress and increased work of breathing. This compensatory mechanism suggests impending respiratory failure or severe hypoxemia. This is an acute, life-threatening physiological manifestation demanding immediate nursing assessment and intervention to prevent respiratory arrest and optimize oxygenation.
Choice C rationale
Dependent edema and clubbed fingers are chronic manifestations of long-standing respiratory and/or cardiovascular compromise, often seen in advanced COPD or cor pulmonale. While indicative of significant disease progression, they do not represent an acute, life-threatening emergency demanding immediate assessment over active respiratory distress. These are chronic adaptations, not acute decompensation.
Choice D rationale
A chronic cough with thick, tenacious secretions is a common symptom in COPD, indicating impaired mucociliary clearance and chronic inflammation. While these symptoms can exacerbate acute respiratory issues, they do not inherently suggest the acute, life-threatening respiratory distress seen in a client using accessory muscles, thus not requiring the absolute first assessment.
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