NUR 325 Quiz I - glucocorticosteroid. Which intervention should ...

NUR 325 Quiz I

• The client with seasonal allergic rhinitis is prescribed fluticasone (Flonase), an intranasal

glucocorticosteroid. Which intervention should the nurse imple- ment first?

Answer Assess the nares for excoriation or bleeding

• The nurse on a medical unit is providing discharge instructions to a client who is prescribed

fluticasone (AeroBid), a glucocorticoid, and a metered-dose inhaler. Which statement by the client would warrant intervention?

Answer I will hold the medication in my mouth for 10 seconds

• fluticasone action
• how to d/c
• what kind of subtances
• increase production of

• decreased activation of

Answer

• most potent natural antiinflammatory substance

• dampen activation of the inflammatory cells
• increase production of antiinflammatory mediators
• SHOULD NOT BE ABRUPTLY D/Cd
• fluticasone RN implications

• when to contact provider

• what happens during prolonged therapy

Answer

• resp status and lung sounds

• assess for s/sx of adrenal insuficciency (anorexia, nausea, weakness, fatigue, hypotension,

hypoglycemia) - if these s/sx appear contact HCP IMMEDIATELY 1 / 4

• withdrawal symptoms
• may caused decrease bone mineral density during prolonged therapy
• adrenal function tests
• increase in serum and urine glucose
• fluticasone RN implication
• when to administer when taking w/ a bronchodilator [albuterol]

• when to notify HCP

Answer

• use bronchodilator first, allow 5 min to elapse before administering corticosteroids

• notify HCP if sore throat or moth

-

• Albutero class

Answer

• beta 2 agonist

• albuterol asthma attack

Answer

• used during attacks because of fast action

• Which intervention should the nurse implement for the client experiencing bronchospasms?

Answer administer albuterol (bronchodilator) via a nebulizer

• The client is prescribed albuterol (Ventolin), a sympathomimetic bron- chodilator, metered-

dose inhaler. Which behavior indicates the teaching con- cerning the inhaler is effective?

Answer the client exhales and then squeezes the canister as the next inspiration occurs

• The 6-year-old child is experiencing an acute exacerbation of reactive airway disease. The

child passed out, and the parents brought the child to the emergency depart- ment. Which 2 / 4

intervention should the nurse implement first?

Answer administer O2 to maintain O2 sat above 95%

• albuterol class and action

Answer class

• beta adrenergic agonist action
• bronchodilation by producing cAMP
• albuterol RN implications
• VS
• lung.... and secretions....

• what if the pt has CV disease?

Answer

- BP, RR, HR

• lung sounds and character of secretions
• pts w/ Cardiovascular problems should be monitors for ECG changes and chest pain
• pt family teaching for albuterol
• what to encourage
• what to avoid, why?
• what env things to avoid

• how long to allow between albuterol and other meds?

Answer

• encourage light (2000 ml/day)

• avoid OTC cough, cold, breathing preapartion --> can increase side effects of arrhythmia
• avoid smoking and other irritants
• use bronchodilator (Albuterol) first and allow 5 mins to elapse before adminitering other

meds

• The 24-year-old client diagnosed with a traumatic brain injury is being transferred to a

rehabilitation unit.Which healthcare provider order should the nurse question?

• Physical therapy to work on lower extremity strength daily.
• Occupational therapy to work on cognitive functioning bid. 3 / 4

• A soft diet with mechanical ground meats and thickening agent in fluids.

• Methylprednisolone (Solu-Medrol), a steroid, IVP q 6 hours.

Answer

• client going to rehanb should not require an IV

• A client is receiving methylprednisolone (Solu-Medrol) 40 mg IV daily.The nurse

anticipates an increase in which laboratory value as the result of this medication?

Answer serum glucose

• The client with a head injury is admitted into the intensive care unit (ICU). Which health-

care provider medication order would the ICU nurse question?

• Osmitrol (Mannitol), an osmotic diuretic.
• Methylprednisolone (Solu-Medrol), a corticosteroid.
• Phenytoin (Dilantin), an anticonvulsant.

• Oxygen, 6 L via nasal cannula.

Answer 2

• The nurse is administering methylprednisolone sodium succinate

(Solu-Medrol), a glucocorticoid, intravenous push to a client diagnosed with pericarditis. The client has a saline lock in the left forearm. After the nurse reconstitutes the powdered medication in the Act-O-Vial, which intervention should the nurse implement?

Answer flush the saline lock

administer the diluted med flush saline lock

• The nurse is caring for a client newly diagnosed with immunohemolytic anemia. Which

medication should the nurse anticipate the HCP ordering?

Answer

• methylprednisolone (steroids)
• / 4