A nurse is providing teaching to a client who has emphysema and a new prescription for theophylline. Which of the following instructions should the nurse provide?
Increase fluids to 1L/per day.
Administer the medication with food.
Consume a high-protein diet.
Avoid caffeine while taking this medication.
The Correct Answer is D
A. Increase fluids to 1L/per day. Clients with emphysema are often encouraged to increase fluid intake beyond 1 liter to help thin secretions, but 1 liter per day is generally insufficient.
B. Administer the medication with food. Theophylline should not necessarily be taken with food; it is generally taken on an empty stomach, but it can be taken with food if gastrointestinal upset occurs.
C. Consume a high-protein diet. High-protein diets may increase the metabolism of theophylline, potentially decreasing its therapeutic effect. Dietary considerations for theophylline involve avoiding caffeine.
D. Avoid caffeine while taking this medication. Theophylline is a methylxanthine, similar to caffeine, and consuming caffeine can increase the risk of side effects like tachycardia, nervousness, and insomnia.
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Correct Answer is B
Explanation
A. Distribution of protein: While protein distribution may be affected in kidney disease, it is not a primary function of the kidneys.
B. Filtration of the blood: The kidneys are responsible for filtering waste products and excess substances from the blood. In kidney failure, this filtration process is impaired, leading to the accumulation of toxins in the body.
C. Metabolism of medications: Although the kidneys do play a role in drug excretion, drug metabolism primarily occurs in the liver. Kidney failure may affect the excretion phase.
D. Ability to hold urine: While kidney failure can affect urinary function, the ability to hold urine is primarily a bladder function, not directly a function of the kidneys.
Correct Answer is C
Explanation
A. "Use the peak expiratory flow meter once per week." The peak expiratory flow meter is usually recommended for daily use in asthma management to monitor lung function and detect any changes early.
B. "Take cromolyn sodium at the first sign of breathing difficulty." Cromolyn sodium is a mast cell stabilizer and is used as a preventative medication rather than for quick relief of symptoms, so it should be taken regularly as prescribed, not only when symptoms arise.
C. "Avoid triggers that cause an attack." Avoiding known asthma triggers is an important part of asthma management to prevent attacks and exacerbations.
D. "You should stop playing basketball, but you can swim instead." Exercise should not necessarily be avoided; instead, it should be managed appropriately with pre-treatment if needed. Avoiding all sports activities is not generally recommended.