Asthma/COPD
Which of these drugs are NOT maintenance for asthma?
A) formoterol
B) beclomestasone
C) levalbuterol
D) montelukast
C; levalbuterol is a rapid acting
Your patient has sudden chest pain and SOB. What medication would they take immediately?
Nitroglycerin
We have a patient who goes home with a beta blocker. We need to teach them to assess their heart rate and hold if their heart rate is under what?
50-60 BPM
What are our side effects of beta blockers and what do they end in?
hypotension, bronchospasm, bradycaradia (3 B's)
end in -lol
A nurse is teaching a client about beta blocker therapy. Which statement indicates understanding?
A. “I will report shortness of breath or wheezing to my provider.”
B. “I can stop taking my medication if my blood pressure returns to normal.”
C. “I should avoid checking my pulse every day.”
D. “This medication might cause my heart to race.”
A; Beta blockers can cause bronchospasm, especially in clients with respiratory conditions, and should be reported immediately.
What do corticosteroids do for our asthma and COPD patients?
decrease the inflammation in the airways
What do our ACE inhibitors end in?
-pril
You have a patient who is on a metered dose inhaler. How would you teach them to use this?
First you shake it, then you press the button and breathe in at the same time. Hold your breath for 5-10 seconds.
A nurse is monitoring a client taking amlodipine (Norvasc). Which finding requires immediate intervention?
A. Peripheral edema
B. Mild dizziness
C. Constipation
D. Headache
A; a big side effect of our calcium channel blockers is edema (amlodipine, verapamil, diltiazem)
You have a patient with asthma who recently was diagnosed with HF. Which medication would you question?
A) atorvastatin
B) metoprolol
C) nitroglycerin
D) verapamil
B; due to it being a beta blocker, which causes bronchospasms
Rapid acting bronchodilator; albuterol or levalbuterol
You have a patient on spironolactone. What electrolyte imbalance do we need to monitor for?
HYPERkalemia; this is potassium sparring
A nurse is preparing to administer a bronchodilator (albuterol) and an inhaled corticosteroid (fluticasone) to a client with asthma. Which medication should the nurse administer first?
A. Administer the fluticasone first, then the albuterol after 5 minutes.
B. Administer the albuterol first, then the fluticasone after 5 minutes.
C. Administer both medications at the same time for best absorption.
D. The order of administration does not matter.
B; take bronchodilator first and then steroid
You have a patient on furosemide for edema related to HF. What electrolyte imbalance is our priority?
hypokalemia
The nurse should teach a client taking furosemide (Lasix) to:
A. Increase potassium-rich foods in the diet
B. Restrict fluids to prevent dehydration
C. Take the medication at bedtime
D. Avoid sunlight while on this medication
A; due to furosemide potentially causing hypokalemia
You have a patient on an inhaled corticosteroid. What do you want to teach them to do after administration and why?
rinse out the mouth to prevent oral thrush
What do our -statins do?
lower cholesterol levels in the blood
How do you instruct someone to take nitroglycerin?
Take 1 every 5 minutes up to 3 times until you have chest pain relief; once you take 3 with no chest pain relief, go to the ED
You have a patient on an ACE inhibitor who starts experiencing angioedema. What are your next steps?
Make sure you establish an airway and continuous airway monitor. You then would want to switch their ACE inhibitor to an ARB.
A nurse is reviewing lab results for a client taking captopril (Capoten). Which finding requires immediate action?
A. Potassium level of 5.8 mEq/L
B. Sodium level of 138 mEq/L
C. Creatinine level of 0.9 mg/dL
D. Blood pressure of 128/78 mmHg
A; captopril is an ACE inhibitor, which can cause hyperkalemia. The potassium requires immediate action
What are side effects of our short acting bronchodilators (albuterol and levalbuterol)?
tachycardia, tremors, anxiety, shakiness
What do beta blockers do?
blocks the SNS (fight or flight) --> decreases HR & BP
A nurse is teaching a client prescribed lisinopril (Prinivil) for hypertension. Which adverse effect should the nurse instruct the client to report immediately?
A. Headache
B. Persistent dry cough
C. Swelling of the lips and tongue
D. Fatigue
C; This indicates angioedema, a serious adverse reaction that can cause airway obstruction.
What is our most concerning side effect of our -statins?
muscle pain; may need to stop or have some sort of medications for this
A nurse is instructing a client with asthma who has been prescribed fluticasone (Flovent). Which statement indicates the need for further teaching?
A. “I should rinse my mouth after using this inhaler.”
B. “This medication will help reduce inflammation in my lungs.”
C. “I should use this medication to stop an asthma attack.”
D. “It may take several days before I notice improvement.”
C; Inhaled corticosteroids are maintenance medications, not for acute attacks.