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 ["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) Beta-Blockers: The use of beta-blockers is a direct contraindication to albuterol administration. Albuterol is a beta-agonist that works by stimulating beta-2 adrenergic receptors to cause bronchodilation. Beta-blockers can antagonize this effect, potentially leading to increased bronchospasm and worsening asthma symptoms. Therefore, if a client is on beta-blockers, caution must be exercised when administering albuterol.
B) Anticholinergics: Anticholinergics, such as ipratropium, are often used in conjunction with beta-agonists like albuterol to provide synergistic effects in managing asthma. There are no direct contraindications between anticholinergics and albuterol, and they can be used together safely to improve bronchial dilation and mucus clearance.
C) Antihistamines: Antihistamines are not contraindicated with albuterol. While they may be used for managing allergic reactions and symptoms, they do not interfere with the action of beta-agonists. Therefore, a client taking antihistamines can still safely receive albuterol for acute asthma attacks.
D) Glucocorticoids: Glucocorticoids, such as prednisone, are often used in asthma management for their anti-inflammatory properties. They are not contraindicated with albuterol; in fact, they are commonly used together in asthma treatment plans. Glucocorticoids help to reduce airway inflammation, while albuterol provides quick relief from bronchospasm.