JenniferHoffmanvsimpostquiz WhilecaringforMs.Hoffman,thenurserecognizeswhichofthefollowingclinicalmanifestations areindicativeofanacuteasthmaattack?(Selectallthatapply.) Cough,Wheezing,Dyspnea
Rationale:Coughisaclassicmanifestationofasthma;sometimes,itmaybetheonlysign.
Wheezingisassociatedwithturbulentairflowandsmallairwayvibrationinwhichthereispartial obstruction,whichiswhatoccursphysiologicallyinthelungsduringanasthmaattack.Stridoris causedwhenturbulentairflowsthroughanarrowedtracheaorlarynx,whereasasthmaisa lowerrespiratorydisorder.Finecracklesareassociatedwithbronchitisorpneumoniaandare discontinuouspoppingsoundsheardinlateinspiration;theyoriginateinthealveoli.Dyspneais shortnessofbreath,whichindicatestheclientishavingdifficultybreathing.Rhonchiare low-pitchedgurglingsoundsproducedbysecretionswithinthelargerairway;theyarenot representativeofairwayobstruction.AfterMs.Hoffman'sasthmaattackresolves,thenurseaskstoreviewhercurrentmedications.Duringthediscussion,Ms.Hoffmansharesthatshetookasthmamedication,butitdidnothelp.ThenurserecognizesthatMs.Hoffmanmayhaveusedtheincorrectmedicationtorelievethe symptomsofanasthmaattack.Thenurseshouldincludewhichofthefollowingasrescue medicationstotakeatthebeginningofanasthmaattack?(Selectallthatapply.) Albuterol,Ipratropium,Levalbuterol Rationale:Albuterolandlevalbuterolareclassifiedasshort-actingbeta2agonists,whichmeans theyprovidereliefofacutesymptomsthroughbronchodilation.Theybindtothebeta2 adrenergicreceptor,whichproducessmoothmusclerelaxationanddecreases bronchoconstriction.Ipratropiumisindicatedforreliefofacutebronchospasmbecauseit inducesbronchodilatationthroughinhibitionofmuscariniccholinergicreceptors.Formoteroland salmeterolarelong-actingbeta2agoniststhataregiventopreventsymptomsofasthmaand areinappropriatetobegiveninanemergencysituation.Inanasthmaattack,aquick-acting inhalershouldbeused.Therehavebeenasthmadeathsrelatedtoclientsusingalong-acting beta2agonistinsteadofashort-actingbeta2agonist.Budesonideisaninhaledcorticosteroid givenforlong-termpreventionofsymptomsandsuppression,control,andreversalof inflammation.Itdoesnothaveaquickaction;therefore,itwouldnotbeusedtoterminatean asthmaattack.
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