A nurse is caring for a client who is taking fluticasone due to chronic allergies. The nurse should monitor the client for which of the following adverse effects?
Hypertension
Fungal infections
Decreased immunity
Hypoglycemia
The Correct Answer is B
A. Hypertension: Fluticasone, a corticosteroid, is not typically associated with causing hypertension directly. However, chronic use can lead to fluid retention and hypertension in some individuals, but it is not a primary concern compared to other side effects.
B. Fungal infections: This is a significant adverse effect associated with inhaled corticosteroids like fluticasone. Prolonged use can increase the risk of oral thrush and other fungal infections due to the immunosuppressive effects of corticosteroids. Monitoring for signs of infection is crucial.
C. Decreased immunity: While long-term use of systemic corticosteroids can lead to decreased immune function, inhaled fluticasone is less likely to cause significant immunosuppression. However, it can still impact local immunity in the airways, making monitoring for infections more relevant than generalized immune suppression.
D. Hypoglycemia: Fluticasone is not known to cause hypoglycemia. In fact, corticosteroids typically can lead to increased blood glucose levels rather than lowering them, especially with chronic use, making this option inaccurate in the context of monitoring for adverse effects.
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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 C
Explanation
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.