A nurse is teaching the parents of a child who is to start using a metered-dose inhaler (MDI) to treat asthma. Which of the following information should the nurse include in the teaching?
"The spacer increases the amount of medication delivered to the oropharynx."
"The spacer increases the amount of medication delivered to the lungs."
"Inhale rapidly using the spacer with the MDI."
"Cover exhalation slots of the spacer with lips when inhaling."
The Correct Answer is B
A. This statement is incorrect; the spacer does not primarily increase medication delivery to the oropharynx.
B. The spacer helps to increase the amount of medication that reaches the lungs by allowing larger particles to settle out and preventing them from being deposited in the mouth and throat.
C. Inhaling slowly and deeply is recommended for effective medication delivery when using an MDI with a spacer.
D. Covering the exhalation slots would prevent proper airflow and could cause the child to inhale exhaled air, which is not recommended during inhalation.
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Correct Answer is C
Explanation
A. Clients on digoxin should actually have an adequate intake of potassium, as low potassium levels can increase the risk of digoxin toxicity.
B. If a pediatric client spits out digoxin, the dose should not be repeated automatically; instead, the nurse should assess the situation and follow the facility's protocol regarding missed doses.
C. Measuring the apical pulse for one full minute before administering digoxin is critical; if the pulse is below the established threshold (usually <60 bpm for children), the medication should be held and the provider notified.
D. While evaluating for nausea, vomiting, and anorexia is important, it is not an appropriate immediate action before administering the medication. The priority action is to assess the apical pulse.
Correct Answer is C
Explanation
A. Encouraging the adolescent to spend more time alone may reinforce their withdrawal and does not promote social interaction or engagement.
B. Assigning the adolescent as a leader may increase anxiety and exacerbate their withdrawal rather than encourage socialization.
C. One-on-one counseling can provide a safe space for the adolescent to express feelings and explore the reasons for their withdrawal, which is a supportive and therapeutic intervention.
D. Focusing solely on academic achievements may lead to further isolation and does not address the need for social skills development and peer interaction.