A nurse is assessing a client’s cranial nerves as part of a neurological examination. Which of the following actions should the nurse take to assess cranial nerve III?

Choice A reason: Attaching a humidifier bottle to the base of the flow meter is a correct action for the nurse to take for a client who has pneumonia and a prescription for oxygen therapy at 5 L/min via nasal cannula. A humidifier bottle adds moisture to the oxygen gas, which can prevent dryness and irritation of the nasal passages and the mucous membranes. A humidifier bottle is recommended for oxygen flow rates above 4 L/min.

Choice B reason: Securing the oxygen tubing to the bed sheet near the client’s head is not a correct action for the nurse to take for a client who has pneumonia and a prescription for oxygen therapy at 5 L/min via nasal cannula. Securing the oxygen tubing to the bed sheet can cause the tubing to kink or twist, which can reduce the oxygen flow or delivery. The nurse should secure the oxygen tubing to the client’s clothing or gown, and ensure that there is enough slack to allow the client to move comfortably.

Choice C reason: Applying petroleum jelly to the nares as needed to soothe mucous membranes is not a correct action for the nurse to take for a client who has pneumonia and a prescription for oxygen therapy at 5 L/min via nasal cannula. Petroleum jelly is a flammable substance that can ignite when exposed to oxygen. The nurse should avoid using petroleum jelly or any other oil-based products on the client’s face or nose when using oxygen therapy. The nurse should use water-based products, such as saline gel or nasal spray, to moisturize the nares and mucous membranes.

Choice D reason: Removing the nasal cannula while the client eats is not a correct action for the nurse to take for a client who has pneumonia and a prescription for oxygen therapy at 5 L/min via nasal cannula. Removing the nasal cannula can cause hypoxia, which is a low level of oxygen in the blood. The nurse should keep the nasal cannula in place while the client eats, and monitor the client’s oxygen saturation and respiratory status. The nurse should also assist the client with eating, and encourage small bites and sips to prevent aspiration.

Choice A reason: This is incorrect. Taking the albuterol before taking the cromolyn is not necessary. Albuterol and cromolyn are both used to treat asthma, but they have different mechanisms of action. Albuterol is a bronchodilator that relaxes the muscles around the airways and opens them up, making it easier to breathe. Cromolyn is a mast cell stabilizer that prevents the release of substances that cause inflammation and allergy symptoms in the airways. Albuterol is used to relieve acute asthma attacks, while cromolyn is used to prevent chronic asthma symptoms. The nurse should advise the client to use albuterol as needed for quick relief, and to use cromolyn regularly as prescribed to prevent asthma flareups.

Choice B reason: This is incorrect. Using both medications immediately after exercising is not recommended. Exercise can trigger asthma symptoms in some people, such as wheezing, coughing, or shortness of breath. This is called exercise induced bronchoconstriction (EIB) or exercise induced asthma (EIA). The nurse should advise the client to use albuterol 15 to 30 minutes before exercising to prevent EIB or EIA, and to avoid exercising in cold, dry, or polluted air. The nurse should also instruct the client to use cromolyn at least 15 minutes before exercising, as it takes time to work and does not provide immediate relief. The nurse should also tell the client to stop exercising and use albuterol if asthma symptoms occur during or after exercising.

Choice C reason: This is incorrect. Using cromolyn immediately if the breathing begins to feel tight is not effective. Cromolyn is not a rescue medication that can provide quick relief of asthma symptoms. It is a preventive medication that works by reducing the inflammation and sensitivity of the airways over time. The nurse should advise the client to use albuterol instead of cromolyn if the breathing begins to feel tight, as albuterol can rapidly open up the airways and ease the breathing. The nurse should also instruct the client to seek medical attention if the albuterol does not work or if the symptoms get worse.

Choice D reason: This is correct. Administering the medications 10 minutes apart is good practice. Cromolyn and albuterol can be used together to treat asthma, but they should not be mixed in the same nebulizer, as they may not be compatible and may lose their effectiveness. The nurse should instruct the client to use separate nebulizers for each medication, and to wait at least 10 minutes between each nebulization to allow the medication to reach the lungs and avoid irritation of the airways. The nurse should also teach the client how to use the nebulizer properly, and how to clean and store it after each use.