A nurse is talking with a client who has a new prescription for an ipratropium inhaler to treat exercise-induced bronchospasm.
Which of the following client statements should the nurse report to the provider?
“I hope this new medication won’t make my high blood pressure worse.”.
“I want to keep using my albuterol when I feel like I need it.”.
“I am allergic to atropine.”.
“I usually have a glass of red wine with dinner.”.
The Correct Answer is C
Choice A rationale
Ipratropium inhalers can potentially increase heart rate and blood pressure, but this is not a common side effect. The concern about high blood pressure is valid but not as critical as an allergy to atropine.
Choice B rationale
Using albuterol with ipratropium is common practice for managing bronchospasm. There is no contraindication for using both medications together.
Choice C rationale
An allergy to atropine is significant because ipratropium is chemically related to atropine. This could lead to a severe allergic reaction.
Choice D rationale
There are no known interactions between ipratropium and alcohol. However, it is always best to consult with a healthcare provider regarding alcohol consumption while on medication.
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Correct Answer is ["A","B","C"]
Explanation
Choice A rationale
Potassium level should be reviewed because captopril can cause hyperkalemia due to its effect on aldosterone secretion.
Choice B rationale
WBC with differential should be reviewed because captopril can cause neutropenia or agranulocytosis, especially in patients with renal impairment or collagen vascular disease.
Choice C rationale
BUN level should be reviewed because captopril can affect renal function, leading to increased BUN levels.
Choice D rationale
Hemoglobin level is not typically affected by captopril, so it is not a priority for review.
Choice E rationale
Glucose level is not typically affected by captopril, so it is not a priority for review.
Correct Answer is ["A","B","C","D","F"]
Explanation
Choice A rationale
Assessing the client’s gag reflex before offering oral intake is essential to prevent aspiration. The gag reflex may be diminished after moderate sedation and the use of local anesthetics during bronchoscopy.
Choice B rationale
Listening to the client’s breath sounds is important to detect any abnormalities, such as wheezing, crackles, or decreased breath sounds, which could indicate complications like bronchospasm or pneumothorax.
Choice C rationale
Monitoring the client’s oxygen saturation is crucial to ensure adequate oxygenation and detect any signs of respiratory distress or hypoxemia following the procedure.
Choice D rationale
Monitoring the client for manifestations of bleeding is necessary because bronchoscopy can cause trauma to the airways, leading to bleeding. Signs of bleeding may include hemoptysis or a drop in hemoglobin levels.
Choice E rationale
Assessing the client’s puncture site is not applicable in this context, as bronchoscopy does not involve a puncture site. This option is incorrect.
Choice F rationale
Observing the client for manifestations of a pneumothorax is important because bronchoscopy can occasionally cause a pneumothorax, especially if a biopsy is performed. Signs of pneumothorax include sudden chest pain, dyspnea, and decreased breath sounds on the affected side. .