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 A
Explanation
Choice A rationale
Lactulose is a synthetic sugar used to treat hepatic encephalopathy by reducing the absorption of ammonia in the intestines. Ammonia is a neurotoxin that can impair mental status in patients with liver dysfunction. By decreasing ammonia levels, lactulose helps improve cognitive function and mental status in patients with hepatic encephalopathy.
Choice B rationale
While lactulose can cause diarrhea as a side effect, the therapeutic goal in hepatic encephalopathy is not to reduce the number of liquid stools but to lower ammonia levels in the blood. The reduction in ammonia levels leads to improved mental status, not necessarily a reduction in liquid stools.
Choice C rationale
The ability to ambulate independently is not a direct therapeutic response to lactulose. The primary goal of lactulose therapy in hepatic encephalopathy is to improve mental status by reducing ammonia levels, not to enhance physical mobility.
Choice D rationale
Lactulose does not have a direct effect on urine output. Its primary mechanism of action is to reduce ammonia absorption in the intestines, thereby improving mental status in patients with hepatic encephalopathy.
Correct Answer is C
Explanation
Choice A rationale
Offering mouthwash for thorough cleansing after brushing teeth can be too harsh for clients with painful mouth ulcers caused by Candida albicans. It may cause further irritation and discomfort.
Choice B rationale
While assistive personnel can help with personal care, oral care should not be left solely to the nurse. Providing appropriate tools and guidance for the client to perform oral care is essential.
Choice C rationale
Providing a soft-bristled toothbrush is appropriate for clients with oral Candida albicans. It helps in gentle cleaning without causing additional pain or damage to the mucosa.
Choice D rationale
Wearing sterile gloves is not necessary for routine oral care. Clean gloves are sufficient unless there is a specific need for sterility, such as in surgical procedures.