A client diagnosed with chronic obstructive pulmonary disease (COPD) is given a new prescription for tiotropium via an inhalation device. Which statement indicates the client understands the instructions for using this medication?
I should use this medication in its handihaler every day.
I will use my other inhaler in between uses.
When I cough up sputum, the secretions should be less thick.
If I have sudden shortness of breath, I will use this inhaler.
The Correct Answer is A
Choice A rationale
Tiotropium is a long-acting bronchodilator used daily to manage chronic obstructive pulmonary disease (COPD). It helps to relax the muscles around the airways, making it easier to breathe. This medication is not intended for immediate relief of acute symptoms but for long-term control of COPD1.
Choice B rationale
Using another inhaler in between uses of tiotropium is not necessary unless prescribed by a healthcare provider. Tiotropium is meant to be used daily, and other inhalers may be prescribed for different purposes, such as rescue inhalers for sudden symptoms.
Choice C rationale
While tiotropium can help improve breathing and reduce symptoms over time, it is not specifically indicated to reduce the thickness of sputum. Other medications or treatments may be needed to address sputum consistency.
Choice D rationale
Tiotropium is not a rescue inhaler and should not be used for sudden shortness of breath. Rescue inhalers, such as albuterol, are designed for immediate relief of acute symptoms.
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Correct Answer is B
Explanation
Choice A rationale
Obtaining vital signs every 2 hours is important for monitoring the patient’s overall condition, but it is not the immediate priority following the surgical removal of glass from the eye.
Choice B rationale
Providing an eye shield to be worn while sleeping is crucial to protect the eye from injury and promote healing after the surgical removal of glass. This intervention helps prevent accidental rubbing or pressure on the eye.
Choice C rationale
Teaching a family member to administer eye drops is important for ongoing care, but it is not the immediate priority following the procedure. The immediate focus should be on protecting the eye and ensuring proper healing.
Choice D rationale
Encouraging deep breathing and coughing exercises is important for preventing respiratory complications, but it is not directly related to the immediate care of the eye following the surgical removal of glass.
Correct Answer is ["A","D"]
Explanation
Choice A rationale:
Enalapril is an ACE inhibitor used to manage hypertension. While it is generally safe, in the context of pneumonia, it can potentially cause complications such as hypotension, especially if the patient becomes septic or dehydrated. Additionally, ACE inhibitors can cause a persistent cough, which might be confused with or exacerbate the symptoms of pneumonia.
Choice B rationale:
Admitting the patient to the medical floor is appropriate given the diagnosis of pneumonia and the patient’s symptoms. Hospitalization allows for close monitoring and administration of necessary treatments.
Choice C rationale:
Sending blood for a complete blood count and electrolytes is standard practice to assess the patient’s overall health and identify any potential complications such as electrolyte imbalances or infection severity.
Choice D rationale:
Supplemental oxygen at 10 L/min via nasal cannula is quite high and typically not the first choice for pneumonia patients. High-flow oxygen therapy or non-invasive ventilation might be more appropriate if the patient requires such high levels of oxygen. Generally, nasal cannulas are used for lower flow rates (up to 6 L/min), and higher flow rates can cause discomfort and nasal dryness.
Choice E rationale:
Ibuprofen is commonly used to manage fever and pain in pneumonia patients. It helps reduce fever and alleviate discomfort, which can improve the patient’s overall condition.
Choice F rationale:
Continuous pulse oximetry is appropriate for monitoring the patient’s oxygen saturation levels, especially given the initial low oxygen saturation on room air.
Choice G rationale:
Vital signs every 4 hours is a standard practice for monitoring patients with pneumonia to detect any changes in their condition promptly.
Choice H rationale:
A chest X-ray is essential for diagnosing and assessing the extent of pneumonia. It helps in identifying the presence of infiltrates, consolidation, or other complications.