Chapter 40: Drugs for Asthma and Other Pulmonary Disorders

Question 1

Identify anatomic structures associated with the lower respiratory tract and their functions

Answer 1

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Question 2

Explain how the autonomic nervous system regulates airflow in the lower respiratory tract and how this process can be modified with drugs

Answer 2

j

Question 3

Compare the advantages and disadvantages of using the inhalation route of administration for pulmonary drugs

Answer 3

e

Question 4

Describe the types of devices used to deliver aerosol therapies via the inhalation route

Answer 4

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Question 5

Compare and contrast the pharmacotherapy of acute and chronic asthma

Answer 5

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Question 6

Describe the nurse’s role in the pharmacologic treatment of lower respiratory tract disorders

Answer 6

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Question 7

What is the representative drug for beta-adrenergic agonists, explain their mechanism of action, primary actions on the respiratory system, and important adverse effects

Answer 7

Drug:
MOA:
Actions:
Side Effects:

Question 8

What is the representative drug for anticholinergics, explain their mechanism of action, primary actions on the respiratory system, and important adverse effects

Answer 8

Drug:
MOA:
Actions:
Side Effects:

Question 9

What is the representative drug for methylxanthines, explain their mechanism of action, primary actions on the respiratory system, and important adverse effects

Answer 9

Drug:
MOA:
Actions:
Side Effects:

Question 10

What is the representative drug for corticosteroids, explain their mechanism of action, primary actions on the respiratory system, and important adverse effects

Answer 10

Drug:
MOA:
Actions:
Side Effects:

Question 11

What is the representative drug for leukotriene modifiers, explain their mechanism of action, primary actions on the respiratory system, and important adverse effects

Answer 11

Drug:
MOA:
Actions:
Side Effects:

Question 12

What is the representative drug for mast cell stabilizers, explain their mechanism of action, primary actions on the respiratory system, and important adverse effects

Answer 12

Drug:
MOA:
Actions:
Side Effects:

Question 13

What is the representative drug for monoclonal antibodies, explain their mechanism of action, primary actions on the respiratory system, and important adverse effects

Answer 13

Drug:
MOA:
Actions:
Side Effects:

Question 14

Use the nursing process to care for patients who are receiving pharmacotherapy for lower respiratory tract disorders.

Answer 14

j

Question 15

Although nonselective beta-adrenergic agonists are infrequently used to treat asthma, they do have some important indications. What are the primary indications for the following non-selective medications: dopamine, epinephrine, and norepinephrine?

Answer 15

k

Question 16

Beta-adrenergic drugs used in the treatment of asthma include short and long-acting drugs. For the treatment of an acute asthma attach, which form of the drug should be used?

Answer 16

k

Question 17

A patient is receiving treatment for asthma with albuterol (Proventil). The nurse teaches the patient that while serious adverse effects are uncommon, the following may occur. (Select all that apply.)

a. Tachycardia
b. Sedation
c. Temporary dyspnea
d. Nervousness
e. Headache

Answer 17

k

Question 18

A patient with asthma has a prescription for two inhalers, albuterol (Proventil) and beclomethasone (Qvar). How should the nurse instruct this patient on the proper use of the inhalers?

a. Use the albuterol inhaler, and use the beclomethasone only if symptoms are not relieved
b. Use the beclomethasone inhaler, and use the albuterol only if symptoms are not relieved
c. Use the albuterol inhaler, wait 5-10 minutes, then use the beclomethasone inhaler
d. Use the beclomesthasone inhaler, wait 5-10 minutes, then use the albuterol inhaler

Answer 18

a. Use the albuterol inhaler, and use the beclomethasone only if symptoms are not relieved

Question 19

A patient has been using a fluticasone (Flovent) inhaler as a component of his asthma therapy. He returns to his healthcare provider’s office complaining of a sore mouth. On inspection, the nurse notices white patches in the patient’s mouth. What is a possible explanation for these findings?

a. The patient has been consuming hot beverages after the use of the inhaler
b. The patient has limited his fluid intake, resulting in dry mouth
c. The residue of the inhaler propellant is coating the inside of the mouth
d. The patient has developed thrush as a result of the fluticasone

Answer 19

d. The patient has developed thrush as a result of the fluticasone

Question 20

A 65-year-old patient is prescribed ipratropium (Atrovent) for the treatment of asthma. Which condition should be reported to the healthcare provider before giving this patient the ipratroprium?

a. A reported allergy to peanuts
b. A history of intolerance to albuterol (Proventil)
c. A history of bronchospasms
d. A reported allergy to chocolate

Answer 20

c. A history of bronchospasms

Question 21

A patient who received a prescription for montelukast (Singular) returns to his provider’s office after 3 days, complaining that “the drug is not working.” She reports mild but continued dyspnea and has had to maintain consistent use of her bronchodilator inhaler, albuterol (Proventil). What does the nurse suspect is the cause of the failure of the montelukast?

a. The patient is not taking the drug correctly
b. The patient is not responding to the drug and will need to be switched to another formulation
c. The drug has not had significant time of use to have full effects
d. The albuterol inhaler is interacting with the montelukast

Answer 21

c. The drug has not had significant time of use to have full effects

Question 22

Vilanterol and fluticasone (Breo Ellipta) has been ordered for a patient with COPD. Because of the combination of drugs, what adverse effects may be expected? (Select all that apply.)

a. Sedation and drowsiness
b. Tremor and nervousness
c. Hypotension
d. Dry mouth and hoarseness
e. Oropharyngeal candidiasis and increased risk of infections

Answer 22

f

Question 23

Caleb Saldano, 9 years old, has a history of asthma. he goes to the health room at his elementary school and states that he has increased shortness of breath and chest tightness. On assessment, you, the school nurse, note scattered expiratory wheezes throughout his upper and middle lung fields and a decreased peak meter flow. The current therapeutic regimen for this child includes salmeterol (Serevent Diskus), two puffs every 12 h; montelukast (Singulair), 5 mg/day PO in the evening; and albuterol (Proventil), two puffs every 4 h prn.

What are the drug classifications and use of the medications that Caleb is taking?

Answer 23

j

Question 24

Caleb Saldano, 9 years old, has a history of asthma. he goes to the health room at his elementary school and states that he has increased shortness of breath and chest tightness. On assessment, you, the school nurse, note scattered expiratory wheezes throughout his upper and middle lung fields and a decreased peak meter flow. The current therapeutic regimen for this child includes salmeterol (Serevent Diskus), two puffs every 12 h; montelukast (Singulair), 5 mg/day PO in the evening; and albuterol (Proventil), two puffs every 4 h prn.

After observing the child’s technique in using the MDI, you wish to reinforce the child’s education as it relates to the administration technique of his inhalants. What areas should be emphasized?

Answer 24

j

Question 25

A 72-year0old male patient has recently been started on an ipratropium (Atrovent) inhaler. What teaching is important for the nurse to provide?

Answer 25

k

Question 26

A 45-year-old patient with chronic asthma is on beclomethasone (Qvar). What must the nuse monitor when caring for this patient?

Answer 26

f