NUR 2571 Rasmussen Final Exam

NUR 2571 Rasmussen Final Exam (Respiratory,Cardiac)

• Asthma

Answer

Chronic inflammatory disorder characterized by episodes of airway inflammation.

• Status Asthmaticus

Answer

Severe asthma attack that does not respond to standard treatment.

Medical emergency!!

• Asthma (Assessment)

Answer

Wheezing Cough Dyspnea Chest tightness

• A client with asthma has a sudden decrease in wheezes .... What does this indicate?

Answer

Airways are closing and causing diminished breath sounds.

Less ventilation is able to occur. This is NOT good! 1 / 3

• Asthma ABGs

Answer

Patient experiencing inflammation in the airways will retain CO2, putting them in respiratory acidosis.

Remember PCO2 levels are 35 - 45; theirs will be increased.

• The nurse is teaching a client with chronic obstructive pulmonary disease (COPD) how to

administer multiple medications by inhalation. Which statement by the client indicates an understanding of the instruction? Select all that apply.

• "If my symptoms get worse, I can double my dosage."
• "I will wait at least 1 minute between use of my different inhalers."
• "I should consult my prescriber before using over-the-counter medications."
• "I cannot rinse my inhaler equipment because it is not supposed to get wet."
• "I should store my inhaler in the refrigerator door between uses."

Answer B, C; The client should wait at least 1 minute between inhalations. OTC products should not be added without consulting the prescriber. Dosages should be taken exactly as prescribed. Inhaler equipment should be cleaned with mild soap, rinsed, and dried daily. The inhaler should be stored at room temperature.

• A client reports nervousness and tremors after beginning drug therapy with salmeterol. Which

statement by the nurse is most appropriate?

• "The symptoms are common at first, but decrease over time."
• "Stop taking the medicine because the symptoms will only get worse."
• "Drinking coffee or tea will help decrease the symptoms."

• "Those symptoms indicate a worsening of the disease process."

Answer

A; Nervousness and tremors might be experienced when salmeterol (a beta-agonist) is newly administered, but they frequently decrease over time. Clients should not

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terminate medication use without consulting the prescriber. Caffeine would exacer- bate the problem. The symptoms are likely related to the medication, and not to the disease process.

• Asthma (Pharmacological Management)

Answer

• Bronchodilators (SABAs)

• Albuterol (ProAir)
• Levalbuterol (Xopenex)

*Bronchodilators (LABAs)

• Salmeterol (Serevent)
• Formoterol (Perforomist)

*Cholinergic Antagonist

• Ipratropium (Atrovent)
• Tiotropium (Spiriva)

*Corticosteroids

• Fluticasone (Ellipta)
• Beclomethasone (Qvar)
• Prednisone PO

• True/False

Long-Acting Beta Antagonists should be used as an emergency in the situation that the client is having an asthma attack.

Answer FALSE

LABAs are PROPHYLACTIC.Should be used daily regardless of asthma activity.

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