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 C
Explanation
A. Friction rub: A friction rub is usually associated with pleuritis, not atelectasis. Atelectasis involves the collapse of alveoli and does not produce this sound.
B. Decreasing respiratory rate: Atelectasis generally leads to an increased respiratory rate as the body compensates for decreased oxygenation.
C. Increasing dyspnea: Increasing dyspnea is common in atelectasis as collapsed alveoli reduce oxygen exchange, leading to shortness of breath and increased respiratory effort.
D. Facial flushing: Facial flushing is not typically associated with atelectasis; instead, atelectasis leads to signs of respiratory distress, such as dyspnea and possibly cyanosis.
Correct Answer is D
Explanation
A. Narrowed pulse pressure: A narrowed pulse pressure can indicate various cardiovascular issues but is not a specific sign of pneumonia.
B. Bradycardia: Bradycardia may occur due to various reasons, including medications or underlying health conditions, but it is not a common sign of pneumonia.
C. Night sweats: While night sweats can occur with pneumonia, they are more associated with infections such as tuberculosis or certain malignancies. It's not a classic presentation.
D. Confusion: Confusion is a common manifestation of pneumonia in older adults due to hypoxia, dehydration, or fever. Older adults often present atypically with changes in mental status during infections.