A client's severe asthma has necessitated the use of a long-acting beta2-agonist (LABA). Which of the client's statements suggests a need for further education?
make sure to use this each time I feel an asthma attack coming on."
"I know that these drugs can sometimes make my heart beat faster."
"I've heard that this drug sometimes gets less effective over time."
"I've heard that this drug is particularly good at preventing asthma attacks during exercise."
The Correct Answer is A
A. "Make sure to use this each time I feel an asthma attack coming on": This statement indicates a need for further education. LABAs are not intended for immediate relief of acute asthma symptoms or attacks; they are designed for long-term control and prevention of symptoms. Clients should use a short-acting beta agonist (SABA) for quick relief during an asthma attack, not a LABA.
B. "I know that these drugs can sometimes make my heart beat faster": This statement reflects an understanding of a potential side effect of LABAs. Increased heart rate is a known side effect, and it is important for clients to be aware of this possibility.
C. "I've heard that this drug sometimes gets less effective over time": This statement is accurate. Tolerance can develop with LABA use, and clients should be informed about this possibility to monitor their symptoms and report any changes to their healthcare provider.
D. "I've heard that this drug is particularly good at preventing asthma attacks during exercise": This statement is correct. LABAs can be beneficial for preventing exercise-induced bronchospasm when used as part of a regular asthma management plan, and clients should understand this use.
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Correct Answer is ["A","C","D"]
Explanation
A) Alternative usage includes being the reversal agent for acetaminophen overdoses: Acetylcysteine is indeed used as an antidote for acetaminophen toxicity. It helps replenish glutathione levels in the liver, thus protecting it from damage caused by the overdose. This is a well-established use of the medication.
B) This medication should not be used for clients with productive coughs: This statement is not correct. Acetylcysteine is used to help thin and loosen mucus, making it easier to expel from the lungs. It can be beneficial for clients with productive coughs, as it aids in reducing excessive respiratory secretions.
C) This medication has a foul smell resembling "rotten eggs": Acetylcysteine has a characteristic odor that is often described as similar to rotten eggs due to the presence of sulfur in its chemical structure. This can be an important consideration for patients when administering the medication.
D) This medication can be utilized in clients with cystic fibrosis. This medication falls under the classification of "mucolytic": Acetylcysteine is classified as a mucolytic agent, making it useful for patients with conditions like cystic fibrosis, where thick mucus production is a significant issue. It helps to decrease the viscosity of secretions, facilitating easier clearance.
E) This medication has anticholinergic properties and side effects: This statement is incorrect. Acetylcysteine does not possess anticholinergic properties. Anticholinergic medications typically reduce secretions and are used for different indications, whereas acetylcysteine serves to increase mucus clearance, not decrease it.
Correct Answer is A
Explanation
A) Cetirizine (Zyrtec): This medication is classified as a second-generation antihistamine. Second-generation antihistamines are designed to be less sedating than first-generation agents, as they are less likely to cross the blood-brain barrier. Cetirizine effectively alleviates symptoms of allergic rhinitis by blocking histamine receptors and is commonly used due to its efficacy and reduced sedation compared to older antihistamines.
B) Chlorpheniramine (Aller-Chlor): Chlorpheniramine is a first-generation antihistamine. It tends to cause more sedation and has a higher likelihood of causing side effects such as drowsiness, dry mouth, and dizziness. First-generation antihistamines are typically less selective and can affect the central nervous system more significantly than their second-generation counterparts.
C) Diphenhydramine (Benadryl): This medication is also a first-generation antihistamine. It is well-known for its sedative effects and is often used for allergic reactions, as well as for its sleep-inducing properties. Like other first-generation antihistamines, diphenhydramine can cause significant drowsiness and other anticholinergic effects.
D) Montelukast (Singulair): Montelukast is not an antihistamine but rather a leukotriene receptor antagonist. It is used for the management of allergic rhinitis and asthma but works through a different mechanism by blocking leukotriene receptors, thereby reducing inflammation and mucus production. It is not classified as an antihistamine, either first or second generation.