A nurse is reviewing the medication administration record (MAR) of a client who requires fluticasone MDI one puff and albuterol MDI two puffs. Which of the following actions should the nurse plan to take? Place the following steps in the correct order. (Move the steps into the box on the right, placing them in the selected order of performance. All steps must be used.)
Have the client take one puff of albuterol
Have the client rest for 1 min
Have the client take the second puff of albuterol
Have the client rest for 5 min
Have the client take one puff of fluticasone
The Correct Answer is A, B, C, D, E
Rationale:
- Administering albuterol first is crucial because it is a bronchodilator that will help open the airways before administering the anti-inflammatory fluticasone.
- The client should rest for 1 minute between puffs of albuterol to allow for the medication to take effect.
- After taking the second puff of albuterol, a longer rest of 5 minutes allows the client to experience the full effects of the bronchodilator.
- Finally, administering fluticasone afterward will help reduce inflammation in the airways, maximizing the benefit of both medications.
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Correct Answer is C
Explanation
Rationale:
A. Bradycardia: Albuterol can cause an increase in heart rate (tachycardia) as a common side effect, not a decrease in heart rate, so bradycardia would not be expected.
B. Wheezing: Albuterol is used to relieve wheezing by causing bronchodilation, so continued wheezing after administration would suggest ineffective treatment rather than being an expected finding.
C. Tremors: Tremors are a common side effect of albuterol due to its stimulation of beta-2 receptors in the muscles. This is often seen after nebulizer treatments.
D. Sleepiness: Albuterol generally causes stimulation of the central nervous system, leading to restlessness or nervousness, not sleepiness.
Correct Answer is B
Explanation
Rationale:
A. Hydrochlorothiazide does not prevent angiotensin II from binding with receptor sites; this action is typically associated with ACE inhibitors or angiotensin receptor blockers.
B. Hydrochlorothiazide decreases the reabsorption of sodium and water in the distal renal tubule, which leads to increased urine output and decreased blood volume, effectively lowering blood pressure.
C. Hydrochlorothiazide does not block beta receptors; this is the mechanism of action for beta-blockers.
D. Hydrochlorothiazide does not promote the movement of extravascular fluids into the vascular compartment; instead, it reduces blood volume by promoting diuresis.