A client who has been diagnosed with exercise-induced asthma is prescribed zafirlukast (Accolate). Which of the following adverse effects would the nurse inform the client regarding zafirlukast (Accolate)?
Liver injury
bradycardia
renal failure
Bronchoconstriction
The Correct Answer is A
A) Liver injury: Zafirlukast (Accolate) has been associated with the risk of liver injury. It is important for clients to be informed about this potential adverse effect, as it may require monitoring of liver function tests during treatment. Symptoms of liver injury, such as jaundice, dark urine, or severe fatigue, should prompt clients to seek medical attention.
B) Bradycardia: Bradycardia is not a commonly associated adverse effect of zafirlukast. This medication primarily works as a leukotriene receptor antagonist and does not typically affect heart rate significantly. Clients should be aware of other more relevant side effects rather than bradycardia.
C) Renal failure: Renal failure is not a known adverse effect of zafirlukast. While kidney function should always be monitored in patients taking various medications, zafirlukast specifically does not have a direct association with renal failure.
D) Bronchoconstriction: While bronchoconstriction is a concern in asthma management, zafirlukast is designed to prevent bronchoconstriction by blocking leukotriene receptors. Therefore, it is not an adverse effect of the medication. In fact, its purpose is to help reduce the incidence of bronchoconstriction and improve asthma control.
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Correct Answer is ["B","D","E","F"]
Explanation
A) Ipratropium is the drug of choice for acute asthma exacerbations: This statement is incorrect. While ipratropium is used in the management of asthma, it is not the first-line treatment for acute exacerbations. Short-acting beta-agonists, such as albuterol, are the preferred choice for rapid relief during an acute asthma attack due to their quick onset of action.
B) Mechanism of action includes blocking acetylcholine receptors in the airway: This statement is accurate. Ipratropium is an anticholinergic agent that works by blocking acetylcholine receptors in the bronchial smooth muscle. This action leads to bronchodilation and helps to decrease mucus production, making it effective for managing airway constriction.
C) Mechanism of action includes antagonizing histamine receptors of the upper airway: This statement is incorrect. Ipratropium does not act on histamine receptors; rather, it specifically targets acetylcholine receptors. Antihistamines are the medications that block histamine receptors, primarily used for allergic reactions and rhinitis, but not for bronchodilation in asthma.
D) Client's who are allergic to soybean should avoid taking ipratropium: This statement is true. Ipratropium bromide may contain soy lecithin, which can pose a risk for patients with soybean allergies. Therefore, it is essential for healthcare providers to assess a patient’s allergy history before prescribing this medication.
E) Urinary retention is a side effect of Ipratropium bromide: This is correct. Anticholinergic medications, including ipratropium, can lead to urinary retention as a side effect due to their action of inhibiting acetylcholine, which plays a role in bladder function. Patients should be monitored for this side effect, especially if they have a history of urinary issues.
F) Ipratropium (Atrovent) is a medication for asthma and chronic obstructive pulmonary disease (COPD): This statement is accurate. Ipratropium is indicated for both asthma and COPD management, as it helps to relieve bronchospasm and improve airflow. It is often used as an adjunct therapy in combination with other bronchodilators for better management of respiratory conditions.
Correct Answer is A
Explanation
A) Beta-Blockers: The use of beta-blockers is a direct contraindication to albuterol administration. Albuterol is a beta-agonist that works by stimulating beta-2 adrenergic receptors to cause bronchodilation. Beta-blockers can antagonize this effect, potentially leading to increased bronchospasm and worsening asthma symptoms. Therefore, if a client is on beta-blockers, caution must be exercised when administering albuterol.
B) Anticholinergics: Anticholinergics, such as ipratropium, are often used in conjunction with beta-agonists like albuterol to provide synergistic effects in managing asthma. There are no direct contraindications between anticholinergics and albuterol, and they can be used together safely to improve bronchial dilation and mucus clearance.
C) Antihistamines: Antihistamines are not contraindicated with albuterol. While they may be used for managing allergic reactions and symptoms, they do not interfere with the action of beta-agonists. Therefore, a client taking antihistamines can still safely receive albuterol for acute asthma attacks.
D) Glucocorticoids: Glucocorticoids, such as prednisone, are often used in asthma management for their anti-inflammatory properties. They are not contraindicated with albuterol; in fact, they are commonly used together in asthma treatment plans. Glucocorticoids help to reduce airway inflammation, while albuterol provides quick relief from bronchospasm.