The nurse is caring for a 18-year-old client who has recently been prescribed montelukast. Which statement made by the client indicates understanding of the newly prescribed medication?
This medication is for long-term treatment for asthma.
This medication has a tendency to produce anaphylaxis.
I can repeat this medication twice prior to seeking medical attention..
Bloodwork is required regularly to monitor the therapeutic levels of this medication.
The Correct Answer is A
A. This medication is for long-term treatment for asthma: This statement indicates an accurate understanding of montelukast. It is a leukotriene receptor antagonist used for long-term control and management of asthma symptoms and to prevent exercise-induced bronchoconstriction.
B. This medication has a tendency to produce anaphylaxis: This statement is incorrect. While allergic reactions can occur with montelukast, it is not commonly associated with anaphylaxis. Clients should be aware of potential side effects, but anaphylaxis is not a common risk.
C. I can repeat this medication twice prior to seeking medical attention: This statement is misleading. Montelukast is taken once daily for asthma management, and it is not meant to be repeated or used as a rescue medication in acute situations. Clients should seek medical attention for worsening symptoms instead of relying on repeating doses.
D. Bloodwork is required regularly to monitor the therapeutic levels of this medication: This statement is incorrect. Montelukast does not require routine blood monitoring for therapeutic levels, unlike some other medications used for asthma management. It is generally well-tolerated without the need for regular blood tests.
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Correct Answer is A
Explanation
A) Beta-Blockers: The use of beta-blockers is a direct contraindication to albuterol administration. Albuterol is a beta-agonist that works by stimulating beta-2 adrenergic receptors to cause bronchodilation. Beta-blockers can antagonize this effect, potentially leading to increased bronchospasm and worsening asthma symptoms. Therefore, if a client is on beta-blockers, caution must be exercised when administering albuterol.
B) Anticholinergics: Anticholinergics, such as ipratropium, are often used in conjunction with beta-agonists like albuterol to provide synergistic effects in managing asthma. There are no direct contraindications between anticholinergics and albuterol, and they can be used together safely to improve bronchial dilation and mucus clearance.
C) Antihistamines: Antihistamines are not contraindicated with albuterol. While they may be used for managing allergic reactions and symptoms, they do not interfere with the action of beta-agonists. Therefore, a client taking antihistamines can still safely receive albuterol for acute asthma attacks.
D) Glucocorticoids: Glucocorticoids, such as prednisone, are often used in asthma management for their anti-inflammatory properties. They are not contraindicated with albuterol; in fact, they are commonly used together in asthma treatment plans. Glucocorticoids help to reduce airway inflammation, while albuterol provides quick relief from bronchospasm.
Correct Answer is C
Explanation
A) Palpitations: While palpitations can be concerning for many medications, they are not a commonly reported side effect of dextromethorphan. This medication primarily acts as a cough suppressant and does not typically have cardiovascular effects that would lead to palpitations. Therefore, clients should not primarily monitor for this side effect when taking dextromethorphan.
B) Hypertension: Dextromethorphan is not generally associated with causing hypertension. Its main action is to suppress the cough reflex, and it does not typically influence blood pressure levels. Patients taking this medication should focus on other side effects rather than worrying about hypertension.
C) Ataxia: Ataxia, or impaired coordination, is a notable adverse effect associated with dextromethorphan, especially at higher doses or when combined with other central nervous system depressants like alcohol. This side effect can lead to dizziness and increased risk of falls or accidents, making it important for clients to be aware of their coordination and alertness levels while on this medication. Advising patients to avoid driving or operating heavy machinery if they experience ataxia is essential for their safety.
D) Diarrhea: Diarrhea is not a common adverse effect of dextromethorphan. The medication is primarily used for its antitussive properties, and gastrointestinal disturbances like diarrhea are generally not associated with its use. If patients experience gastrointestinal symptoms while taking this medication, they may need to consider other factors or medications that could be contributing to those symptoms.