A 10 year old child is brought to a respiratory clinic and is prescribed Atrovent (Ipratropium Bromide). Prior to administering the medication, what would the nurse assess for?
Breath sounds
Cardiac disorders
Recent injuries
Hypertension
The Correct Answer is A
A) Breath sounds: Prior to administering Atrovent (Ipratropium Bromide), it is essential for the nurse to assess the child’s breath sounds. Ipratropium is an anticholinergic medication used to relieve bronchospasm in conditions like asthma or chronic obstructive pulmonary disease (COPD). By evaluating breath sounds, the nurse can assess the severity of the respiratory condition and monitor for any wheezing or crackles, which may indicate the need for further intervention or adjustment of the treatment.
B) Cardiac disorders: While some caution may be warranted in patients with cardiac disorders when using certain medications (e.g., sympathomimetics), Ipratropium Bromide is an anticholinergic agent that primarily affects the respiratory system. It is not directly contraindicated in children with cardiac disorders, so assessing for cardiac conditions is not the most critical initial assessment when administering this drug.
C) Recent injuries: Recent injuries do not specifically relate to the need for assessment prior to administering Ipratropium. This medication targets the lungs and airways, so assessing for recent injuries would not be as pertinent unless the injuries impacted the child’s ability to breathe (e.g., rib fractures, lung trauma).
D) Hypertension: Hypertension is not a primary concern when administering Ipratropium Bromide. While anticholinergic drugs should be used cautiously in certain individuals (e.g., those with glaucoma or urinary retention), hypertension is not a contraindication for this medication. It would be more critical to assess for respiratory status, particularly breath sounds, to evaluate the efficacy of the treatment.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) CSF proteins and an angiography: While cerebrospinal fluid (CSF) analysis is a valuable diagnostic tool in multiple sclerosis (MS), angiography is not typically used in diagnosing MS. Angiography is primarily used to assess blood vessels and would not help in diagnosing a neurological condition like MS, which involves the central nervous system's myelin sheath.
B) Serum anti-acetylcholine antibodies and x-rays: Anti-acetylcholine antibodies are more relevant for diagnosing autoimmune conditions such as myasthenia gravis, not multiple sclerosis. Additionally, x-rays are not useful for diagnosing MS, as MS is primarily a disorder of the central nervous system, and x-rays are not effective in visualizing soft tissues or brain lesions associated with MS.
C) Serum albumin and a computed tomography (CT) scan: Serum albumin levels are not relevant for diagnosing MS. A CT scan may be used in some cases to rule out other conditions, but magnetic resonance imaging (MRI) is more sensitive and specific for diagnosing MS. MRI is particularly effective in detecting the plaques or lesions in the brain and spinal cord that are characteristic of MS.
D) Cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI): This is the correct combination of diagnostic tests for multiple sclerosis. CSF analysis can show elevated levels of immunoglobulin G (IgG) and oligoclonal bands, which are common in MS. MRI is the most sensitive imaging tool for detecting the characteristic plaques or demyelinated areas in the brain and spinal cord, which are hallmarks of MS. Therefore, this combination is the gold standard for confirming the diagnosis of MS.
Correct Answer is C
Explanation
A) Hypothalamus and the medulla: While the hypothalamus and medulla play critical roles in regulating autonomic functions and overall sympathetic nervous system activity, the primary origin of the sympathetic nervous system's neural impulses comes from the spinal cord, specifically in the thoracic and lumbar regions. The hypothalamus and medulla are involved in coordinating and regulating sympathetic activity rather than being the origin of the impulses themselves.
B) Cranium and sacral area of the spinal cord: The cranium and sacral regions are primarily associated with the parasympathetic nervous system, not the sympathetic nervous system. The parasympathetic nervous system's nerve fibers arise from the brainstem and the sacral region, while the sympathetic fibers originate from the thoracic and lumbar areas.
C) Thoracic and lumbar section of the spinal cord: The sympathetic nervous system originates in the thoracolumbar region of the spinal cord, which includes the thoracic and lumbar segments (T1-L2). These regions house the preganglionic neurons whose axons exit the spinal cord and synapse in sympathetic ganglia, leading to the sympathetic effects on organs and tissues. This makes the thoracic and lumbar sections the correct location for the origin of SNS impulses.
D) Nerve membrane: The nerve membrane, or the cellular membrane of individual neurons, is not the location where impulses originate. The origin of the impulses is in the central nervous system (CNS), specifically in the spinal cord for the sympathetic system, not at the level of the individual nerve membranes.
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