A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?
Stores the medication at room temperature.
Attaches spacer device to the inhaler.
Rinses the mouth after each use.
Primes the inhaler with 7 pumps.
The Correct Answer is D
Choice A rationale
Storing the medication at room temperature is appropriate for ipratropium inhalers. This ensures the medication remains effective and safe for use.
Choice B rationale
Attaching a spacer device to the inhaler is recommended for patients using ipratropium inhalers. A spacer helps deliver the medication more effectively to the lungs and reduces the risk of side effects.
Choice C rationale
Rinsing the mouth after each use of the inhaler is a good practice to prevent oral thrush and other side effects. It is a recommended step in the proper use of inhalers.
Choice D rationale
Priming the inhaler with 7 pumps is excessive. Typically, inhalers need to be primed with 2-4 pumps before first use or if they haven’t been used for a while. Over-priming can waste medication and indicate a need for additional teaching.
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Correct Answer is B
Explanation
Choice A rationale
Serum blood glucose level is not directly related to the presence of purulent drainage at a wound site. While blood glucose levels can affect wound healing, they do not provide specific information about the presence of infection.
Choice B rationale
Culture for sensitive organisms is the most appropriate laboratory value to note when purulent drainage is observed. This test helps identify the specific bacteria causing the infection and determines the most effective antibiotics for treatment.
Choice C rationale
C-reactive protein (CRP) level is a marker of inflammation and can indicate the presence of an infection, but it does not provide specific information about the bacteria causing the infection.
Choice D rationale
Blood pH level is not directly related to the presence of purulent drainage at a wound site. While blood pH can be affected by severe infections, it is not a specific indicator of wound infection.
Correct Answer is A
Explanation
Choice A rationale
Isolating the client from others is the most important action to prevent the spread of COVID-19. This includes isolating the client from other clients, family, and healthcare workers not wearing proper PPE2.
Choice B rationale
Reporting the COVID-19 result to the local health department is important but not the immediate priority. Isolation takes precedence to prevent transmission.
Choice C rationale
Teaching the client to wear a mask, hand wash, and social distance is essential but secondary to immediate isolation.
Choice D rationale
Counseling family members to monitor for symptoms is important but not the immediate priority. Isolation of the client is the first step.