A 26-year-old female is brought to the emergency department while having an asthma attack. She is given a nebulizer treatment with the medication albuterol. The nurse's immediate assessment priority would be to
Determine the time of the patient's last meal.
Monitor the patient's temperature and blood pressure.
Monitor respiratory rate and Spo2 with a pulse oximeter.
Provide education on asthma management and treatment.
The Correct Answer is C
During an asthma attack, the primary concern is the patient's ability to breathe and maintain adequate oxygenation. Monitoring the patient's respiratory rate and oxygen saturation (SpO2) with a pulse oximeter provides crucial information about the effectiveness of the albuterol treatment and the patient's respiratory status. It helps determine if the airway is opening up, if oxygen levels are improving, and if the patient is responding positively to the medication.
While determining the time of the patient's last meal can be relevant for certain interventions, it is not the immediate priority during an asthma attack. It is more important to focus on assessing and managing the patient's breathing and oxygenation first.
Monitoring the patient's temperature and blood pressure can be important for a comprehensive assessment, but they are not the immediate priority during an acute asthma attack. Addressing the patient's respiratory distress takes precedence.
Providing education on asthma management and treatment is an important aspect of care, but it should be done after the patient's acute symptoms are addressed and stabilized. In the immediate assessment phase, the focus is on assessing and managing the patient's respiratory status. Education can be provided once the patient's immediate needs are addressed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D"]
Explanation
The nurse should make the following responses regarding how albuterol helps the client's breathing:
- The medication will open the airways.
- The medication will prevent wheezing.
Albuterol is a bronchodilator medication commonly used to treat respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD). It works by relaxing the smooth muscles in the airways, leading to the dilation of the bronchial tubes and increased airflow. This mechanism helps open up the airways and prevent or relieve symptoms such as wheezing, shortness of breath, and chest tightness.
The other options are incorrect because:
The medication will decrease coughing episodes: While albuterol may indirectly reduce coughing episodes by opening up the airways and improving airflow, its primary effect is on bronchodilation rather than directly targeting coughing.
The medication will stimulate the flow of mucus: Albuterol is not known to stimulate mucus flow. Instead, it focuses on bronchodilation to improve airflow in the lungs.
The medication will reduce inflammation: Albuterol is primarily a bronchodilator and does not have a significant anti-inflammatory effect. Other medications, such as corticosteroids, are typically used to address inflammation in respiratory conditions.
Correct Answer is C
Explanation
Dimenhydrinate is an antihistamine commonly used to treat motion sickness and vertigo. One of the common side effects of dimenhydrinate is dizziness. It can cause sedation and impair cognitive and motor functions. Therefore, the client should be advised to be cautious when engaging in activities that require alertness, such as driving or operating machinery. Monitoring for dizziness and taking appropriate precautions can help prevent accidents and ensure the client's safety.
The other options provided in the original response are incorrect:
- Administer 24 hr before effects are desired: This is not a correct instruction for dimenhydrinate. The medication is typically taken 30 minutes to 1 hour before the desired effects, such as before travel to prevent motion sickness.
- Expect an increase in salivation: Dimenhydrinate does not typically cause an increase in salivation. This is not a known side effect of the medication.
- Observe for diarrhea: Diarrhea is not a common side effect of dimenhydrinate. While gastrointestinal disturbances can occur with some antihistamines, it is not typically associated with dimenhydrinate use.
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