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 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","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.