A nurse is caring for a client who presents with chronic obstructive pulmonary disorder (COPD), Which of the following task can the nurse delegate to the UAP?
Administer albuterol via inhalation device to the client.
performing initial respiratory assessment to determine baseline respiratory rate.
Assist the client with oral hygiene following inhaled corticosteroid administration by the nurse.
Assess the client's lung sounds to determine if wheezing is present.
The Correct Answer is C
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.
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Correct Answer is C
Explanation
A) Montelukast (Singulair): This medication is a leukotriene receptor antagonist used to manage asthma and allergic rhinitis. It does not contain soy or soy-derived ingredients, making it a safe option for a client with a soybean allergy. There are no known contraindications related to soy in this medication.
B) Methylprednisolone (Solumedrol): This is a corticosteroid used to reduce inflammation. It is not contraindicated for clients with a soybean allergy, as it does not contain soy-derived components. The medication primarily poses risks related to long-term use, but not specifically regarding soybean allergies.
C) Ipratropium bromide (Atrovent): This medication is an anticholinergic used to relieve bronchospasm. Ipratropium bromide is formulated with soy lecithin, which is derived from soybeans. Therefore, it is contraindicated for clients with a known allergy to soybeans, as it may trigger an allergic reaction.
D) Albuterol (Ventolin): This medication is a short-acting beta-agonist used for quick relief of bronchospasm. It does not contain any soy components and is generally safe for patients with soybean allergies. While there may be other considerations for its use, the allergy to soy is not a concern with this medication.
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.