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 D
Explanation
A. "I will rinse my mouth after each dose to prevent thrush." Ipratropium bromide is an anticholinergic bronchodilator, and it does not typically increase the risk of oral thrush. Rinsing the mouth after use is more commonly recommended with corticosteroid inhalers.
B. "I will use this medication early in the morning so I am not urinating all night." Ipratropium bromide does not significantly affect urination or the frequency of urination, as it primarily targets the respiratory system.
C. "I will make sure to use this in combination with a corticosteroid inhaler." Although it may be used in combination with corticosteroids, this is not specific to Ipratropium's side effects. This answer does not directly address side effect management.
D. "I will suck on hard candies to cope with dry mouth." A common side effect of Ipratropium bromide is dry mouth due to its anticholinergic properties. Sucking on hard candies is an appropriate way to manage this side effect.
Correct Answer is C
Explanation
A. Hypertension: While systemic corticosteroids can lead to hypertension, fluticasone, when inhaled, typically has minimal systemic effects.
B. Polyuria: Polyuria is more associated with systemic corticosteroids or diabetes management, not with inhaled fluticasone.
C. Oral candidiasis: Inhaled corticosteroids like fluticasone can lead to oral thrush, so rinsing the mouth after use is advised to prevent this.
D. Hypoglycemia: Corticosteroids typically cause hyperglycemia rather than hypoglycemia.