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
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.
Correct Answer is C
Explanation
A. CNS Depressants: While there may be general concerns about using multiple medications that affect the central nervous system, CNS depressants do not have a direct interaction with oxymetazoline. Oxymetazoline is primarily a nasal decongestant and its interactions are more specific to other classes of medications.
B. Short Acting Beta Agonist: Short-acting beta agonists (SABAs) are bronchodilators used in asthma management. There is no direct interaction with oxymetazoline; they are used for different purposes and act on different receptors.
C. Monoamine oxidase inhibitors (MAOIs): This option is correct. MAOIs can potentially interact with oxymetazoline, leading to increased blood pressure and other cardiovascular effects. The combination can cause vasoconstriction due to the stimulant effects of both oxymetazoline and the increased levels of norepinephrine resulting from MAOI inhibition.
D. Mast Cell Inhibitors: Mast cell stabilizers do not interact directly with oxymetazoline. These medications are used primarily to manage allergic responses and asthma symptoms and do not have a significant effect on the actions of oxymetazoline.