(Pharmacology) Ch.30 Drugs Used to Treat Lower Respiratory Disease Flashcards
The movement of air in and out of the lungs.
Ventilation
The process by which oxygen passes across the alveolar membrane to the blood.
Diffusion
A condition causing inflammation and edema with excessive mucus secretion.
Asthma
Smooth muscle constriction causing narrowing of the airways.
Bronchospasm
Specialized mucus glands of the respiratory tract
Goblet Cells
A common inflammatory diseases of the bronchi and bronchioles
Bronchitis
Objective: Discuss nursing assessments used to evaluate the respiratory status of a patient.
NCLEX item type: multiple choice
Cognitive skill: take action
A nurse is assessing the patient in scenario #1 and listens to lung sounds. Which findings would the nurse report to the healthcare provider for further evaluation? (484,490)
- Elevated shoulders and use of abdominal
muscles to breathe - Dry nonproductive cough
- Coughing up thin, white secretions
- Rapid, shallow breathing with O, saturation of 88%
- Coughing up thin, white secretions
NCLEX item type: multiple response
Cognitive skill: application
During a respiratory assessment of the patient in scenario #1, the nurse listens to breath sounds and monitors the respiratory rate, as well as what other symptoms? (Select all that apply.) (490)
- Appetite
- Mental status
- Urine output
- Signs of cyanosis
- Use of abdominal muscles during breathing
- Signs of cyanosis
NCLEX item type: multiple response
Cognitive skill: interpret
The nurse will check which laboratory and diagnostic tests in order to understand the patient’s diagnosis? (Select all that apply.) (490)
- ABGs
- Chest X-rays
- Creatinine clearance
- Electrocardiograph
- Pulmonary function tests
- ABGs
- Chest X-rays
- Electrocardiograph
- Pulmonary function tests
NCLEX item type: multiple response
Cognitive skill: explain
The nurse needs to educate patients who have respiratory conditions on important health maintenance aspects, which include what instructions? (Select all that apply.) (491)
- Hand hygiene to prevent infections
- Encourage an increase in fluid intake
- Follow prescribed medications when feeling short of breath
- Humidify the air to relieve dryness
- Use of abdominal muscles during breathing
- Hand hygiene to prevent infections
- Encourage an increase in fluid intake
- Follow prescribed medications when feeling short of breath
NCLEX item type: multiple choice
Cognitive skill: relate
The nurse was discussing the timing of the administration of medications for the patient in scenario #2 with asthma. Which statement by the nurse is correct? (492)
- “It does not matter in which order you take your medications.”
2 “Take your steroid inhaler first, then your bronchodilator.” - “Take your bronchodilator first, then your steroid inhaler.”
- “Take your bronchodilator first, then wait 2 hours before taking your steroid inhaler.”
- “Take your bronchodilator first, then your steroid inhaler.”
NCLEX item type: multiple choice
Cognitive skill: evaluate
The nurse is explaining the different zones of a peak flowmeter to the patient with asthma and how to use it to assess when symptoms are changing. The nurse recognizes that the patient needs further teaching after the patient in scenario #2 makes which statement? (491)
- “The green zone is good, the yellow zone is warning, and the red zone is danger.”
- “I can use the quick-relief medication when I notice that I am in the yellow zone.”
- “The quick-relief medication and corticosteroids are used when I am in the green zone.”
- “The peak flowmeter measures my peak expiratory flow and helps me determine how to manage my asthma.”
- “The quick-relief medication and corticosteroids are used when I am in the green zone.”
Objective: Distinguish the mechanisms of action of expectorants, antitussives, and mucolytic agents.
NCLEX item type: multiple choice
Cognitive skill: compare
The nurse expects that an effective cough suppressant and the standard against which other antitussive agents are compared is which medication? (493)
- codeine
- guaifenesin
- ipratropium
- acetylcysteine
- codeine
- guaifenesin
- ipratropium
NCLEX item type: multiple choice
Cognitive skill: classify
The nurse explains to the patient in scenario #1 that expectorants are those drugs whose action is to do what? (493)
- Relax the smooth muscles of the airway.
- Suppress the cough center in the brain.
- Increase the viscosity of mucus plugs.
- Enhance the flow of respiratory secretions,
which promotes ciliary action.
- Relax the smooth muscles of the airway.
NCLEX item type: multiple choice
Cognitive skill: explain
The nurse was educating the patient on what to expect from mucolytics, and described them as having what action? (495)
- “These agents play an important role in the
treatment of asthma to reduce inflammation.” - “These agents relax the smooth muscle of the
tracheobronchial tree.” - “These agents inhibit a key enzyme from being metabolizes allowing it to accumulate and
reduce inflammation.” - “These agents reduce the stickiness and viscosity of pulmonary secretions by acting directly on the mucus plugs to dissolve them.”
- “These agents reduce the stickiness and viscosity of pulmonary secretions by acting directly on the mucus plugs to dissolve them.”
NCLEX item type: multiple response
Cognitive skill: application
The nurse gives which instructions to a patient prior to the administration of an antitussive agent? (Select all that apply.) (494)
- “Be sure to drink plenty of liquids to keep hydrated.”
- “Remember, this drug may cause you to become sleepy.
- “You need to describe the characteristics of your cough.”
- “It would be wise to record your peak expiratory flow prior to use.”
- “You need to make sure you have your nebulizing equipment for administration.”
- “Remember, this drug may cause you to become sleepy.
- “It would be wise to record your peak expiratory flow prior to use.”
- “You need to make sure you have your nebulizing equipment for administration.”
NCLEX item type: multiple choice
Cognitive skill: compare
When administering guaifenesin to a patient with bronchitis, the nurse expects that the drug will have what effect? (493)
- Dilate the bronchioles
- Thin the bronchial secretions
- Increase the viscosity of mucus secretions
- Increase the frequency of a nonproductive
cough
- Dilate the bronchioles
- Thin the bronchial secretions
NCLEX item type: multiple choice
Cognitive skill: interpret
The nurse will assess the action of acetyleysteine as working when the patient exhibits which symptom? (495)
- Kussmaul’s respiration
- Increased nonproductive coughing
- Thicker and more viscous secretions
- Improved airway flow and more comfortable
breathing
- Increased nonproductive coughing
- Thicker and more viscous secretions
- Improved airway flow and more comfortable
breathing
Objective: Describe the nursing assessments needed to monitor therapeutic response and the development of adverse effects from beta- adrenergic bronchodilator therapy.
NCLEX item type: multiple choice
Cognitive skill: comprehension
The nurse will observe for an expected effect from beta-adrenergic agents on patients with respiratory conditions such as asthma. Which effect will be expected from beta-adrenergic agents? (495-496)
- Bronchodilation causing easier breathing
- Increase in respiratory rate
- Thinner respiratory secretions
- Decrease in peak expiratory flow
- Thinner respiratory secretions
NCLEX item type: extended multiple choice
Cognitive skill: recognize cues
The patient in scenario #2 is given beta-adrenergic agents, and the nurse needs to monitor for which systemic adverse effects? (Select all that apply.) (497)
- Nausea, vomiting
- Sedation
- Urinary retention
- Palpitations
- Restlessness
- Nervousness
- Cardiac arrhythmias
- Lethargy
- Anxiety
- Tachycardia
- Urinary retention
NCLEX item type: multiple response
Cognitive skill: compare
The nurse recognized the short-acting beta-adrenergic agents that have a rapid onset and are used to treat acute bronchospasms as these drugs. Which medications are included in this drug class? (Select
all that apply.) (496)
- albuterol
- dipropionate
- salmeterol
- tiotropium
- levalbuterol
- albuterol
NCLEX item type: cloze
Cognitive skill: recognize cues
Choose the most likely options for the information missing from the statements below by selecting from the list of options provided.
The nurse expects that _____ 1_____ drugs will enhance the effect of beta-adrenergic bronchodilators and inhibit _____2_____.
responses that may in _____3_____. (499)
Objective: Discuss the nursing assessments needed to monitor therapeutic response and the development of adverse effects from anticholinergic bronchodilator therapy.
NCLEX item type: multiple choice
Cognitive skill: illustrate
The nurse reviewed the expected actions of the anticholinergic bronchodilator agents that the patient in scenario #2 was on for treatment asthma. Which effect is the expected outcome for these drugs? (499)
- They inhibit the inflammatory response in the
bronchioles. - They stabilize the mast cells to prevent the
release of histamine. - They block the cholinergic effect of bronchial
constriction by the vagus nerve. - They bind to the circulating antibodies in the
blood, making them not as available to trigger
symptoms.
- They bind to the circulating antibodies in the
blood, making them not as available to trigger
symptoms.
NCLEX item type: multiple response
Cognitive skill: application
The nurse knows anticholinergic agents have potent adverse effects that limit their use. Which effects are important to monitor the patient for who is taking anticholinergic agents? (Select all that apply.) (499)
- Mydriasis
- Bradycardia
- Tachycardia
- Urinary retention
- Throat irritation
- Mydriasis
- Bradycardia
- Tachycardia
NCLEX item type: multiple choice
Cognitive skill: contrast
The nurse reviewed the medications prescribed for the patient in scenario #1. Which ones are used to treat COPD? (Select all that apply.) (498,500)
- tiotropium (Spiriva)
- spironolactone (Aldactone)
- levothyroxine (Synthroid)
- indomethacin (Indocin)
- budesonide (Pulmicort)
- spironolactone (Aldactone)
Objective: Discuss the nursing assessments needed to monitor therapeutic response and the development of adverse effects from corticosteroid inhalant therapy.
NCLEX item type: multiple response
Cognitive skill: application
The nurse will assess the important components of blood gases that indicate overall pulmonary function. Which values are needed to be monitored? (Select all that apply.) (484)
- PaO2
- pH
- PaCO2
- HCO3
- Hgb
- HCO3
NCLEX item type: multiple choice
Cognitive skill: contrast
Which component of blood gases measures the ratio of actual oxygen content of hemoglobin compared with the hemoglobin’s ability to carry oxygen? (484)
- SaO2
- PaO2
- pH
- Paco2
NCLEX item type: multiple response
Cognitive skill: application
What instructions will the nurse give the patient in scenario #2 who is started on systemic steroids for exacerbation of asthma? (499-501)
- “Your corticosteroid inhalant therapy will be discontinued while you take these steroids orally.”
- “Your bronchodilator inhalant agents will be discontinued while you take these steroids orally.”
- “These steroids are given to allow easier breathing with less effort by decreasing pulmonary inflammation.”
4 “The full therapeutic benefit from these systemic steroids may require up to 4 weeks of therapy for maximum benefit.” - “It is important to remember that oral thrush can develop with inhaled steroids as well as large oral doses of corticosteroids, be sure to
gargle and rinse the mouth after treatment.”
- “Your corticosteroid inhalant therapy will be discontinued while you take these steroids orally.”
4 “The full therapeutic benefit from these systemic steroids may require up to 4 weeks of therapy for maximum benefit.”
5. “It is important to remember that oral thrush can develop with inhaled steroids as well as large oral doses of corticosteroids, be sure to
gargle and rinse the mouth after treatment.”