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
Explanation
A) Ipratropium bromide: While ipratropium is used to manage bronchospasm, it is typically not the first choice for acute asthma attacks. It has a slower onset of action compared to short-acting beta-agonists like albuterol and is generally used as an adjunct therapy rather than for immediate relief.
B) Albuterol: This medication is a short-acting beta-agonist that provides rapid relief of bronchospasm during an acute asthma attack. It works by relaxing the muscles in the airways, making it the preferred first-line treatment for quick relief in asthma exacerbations.
C) Salmeterol: This medication is a long-acting beta-agonist (LABA) used for long-term control of asthma symptoms, not for immediate relief. It has a delayed onset of action and should not be used as a rescue medication during an acute attack, as it may take longer to provide effects.
D) Budesonide: This is an inhaled corticosteroid that helps in controlling chronic inflammation associated with asthma. While important for long-term management, it is not effective for the rapid relief of acute symptoms and should not be used during an asthma attack.
Correct Answer is A
Explanation
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.