A client who suffers from severe persistent allergic asthma is prescribed omalizumab (Xolair). Which statement below correctly describes the mechanism of action associated with omalizumab (Xolair)?
Inhibits the production of leukotrienes and histamine, preventing further asthma attacks.
Inhibits mast cells from releasing histamine, preventing further asthma attacks
Selectively binds to IgE, reducing allergic mediators and asthma attacks.
Stimulates alpha-adrenergic receptors to assist in reduction of allergic related symptoms.
The Correct Answer is C
A. Inhibits the production of leukotrienes and histamine, preventing further asthma attacks: This statement is misleading. Omalizumab does not directly inhibit the production of leukotrienes or histamine; rather, it works by targeting IgE, which is involved in the allergic response.
B. Inhibits mast cells from releasing histamine, preventing further asthma attacks: While omalizumab does reduce the overall allergic response, it does so by binding to IgE rather than directly inhibiting mast cell activity. Therefore, this description does not accurately represent its primary mechanism of action.
C. Selectively binds to IgE, reducing allergic mediators and asthma attacks: This statement correctly describes the mechanism of action of omalizumab. By binding to immunoglobulin E (IgE), omalizumab prevents IgE from attaching to mast cells and basophils, thus reducing the release of allergic mediators that contribute to asthma attacks.
D. Stimulates alpha-adrenergic receptors to assist in reduction of allergic-related symptoms: This statement is incorrect. Omalizumab does not stimulate alpha-adrenergic receptors; such action is associated with certain bronchodilators. Omalizumab specifically targets IgE to mitigate allergic responses.
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Correct Answer is C
Explanation
A) Administer albuterol via inhalation device to the client: This task cannot be delegated to the unlicensed assistive personnel (UAP). Administering medications, especially inhaled bronchodilators like albuterol, requires a licensed nurse to ensure proper technique, monitor the client for adverse effects, and assess the effectiveness of the treatment.
B) Performing initial respiratory assessment to determine baseline respiratory rate: This task also cannot be delegated to the UAP. Assessing respiratory status, including determining baseline respiratory rate and identifying any abnormalities, requires critical thinking and clinical judgment that a nurse must perform.
C) Assist the client with oral hygiene following inhaled corticosteroid administration by the nurse: This task can be delegated to the UAP. Assisting with oral hygiene is within the scope of practice for UAPs, and it is essential after administering inhaled corticosteroids to help prevent oral thrush and maintain oral health.
D) Assess the client's lung sounds to determine if wheezing is present: This task cannot be delegated to the UAP. Assessing lung sounds is a critical nursing assessment that requires the knowledge and skills of a licensed nurse to interpret findings and make clinical decisions based on the assessment.
Correct Answer is A
Explanation
A. This medication is for long-term treatment for asthma: This statement indicates an accurate understanding of montelukast. It is a leukotriene receptor antagonist used for long-term control and management of asthma symptoms and to prevent exercise-induced bronchoconstriction.
B. This medication has a tendency to produce anaphylaxis: This statement is incorrect. While allergic reactions can occur with montelukast, it is not commonly associated with anaphylaxis. Clients should be aware of potential side effects, but anaphylaxis is not a common risk.
C. I can repeat this medication twice prior to seeking medical attention: This statement is misleading. Montelukast is taken once daily for asthma management, and it is not meant to be repeated or used as a rescue medication in acute situations. Clients should seek medical attention for worsening symptoms instead of relying on repeating doses.
D. Bloodwork is required regularly to monitor the therapeutic levels of this medication: This statement is incorrect. Montelukast does not require routine blood monitoring for therapeutic levels, unlike some other medications used for asthma management. It is generally well-tolerated without the need for regular blood tests.