A woman with a history of asthma comes to the clinic for evaluation for pregnancy. The woman's pregnancy test is positive. When reviewing the woman's medication therapy regimen for asthma, which medication would the nurse identify as problematic for the woman now that she is pregnant?

ipratropium

albuterol

salmeterol

Prednisone

Answer and Explanation

The Correct Answer is C

A. Ipratropium:

Ipratropium is an anticholinergic bronchodilator used to relieve bronchospasm associated with asthma and chronic obstructive pulmonary disease (COPD). It works by relaxing the muscles around the airways to improve breathing. In pregnant women with asthma, ipratropium is generally considered safe for use when the benefits of controlling asthma symptoms outweigh the potential risks to the fetus. It is minimally absorbed systemically, reducing the risk of systemic side effects for both the mother and the fetus.

B. Albuterol:

Albuterol is a short-acting beta agonist (SABA) commonly used as a rescue inhaler for acute asthma symptoms. It works by relaxing the muscles in the airways, making it easier to breathe. Albuterol is considered safe for use during pregnancy, and it is often recommended as needed to relieve bronchospasm in pregnant women with asthma. Controlling asthma symptoms with albuterol can help improve maternal oxygenation and prevent complications associated with poorly controlled asthma during pregnancy.

C. Salmeterol:

Salmeterol is a long-acting beta agonist (LABA) used for the long-term control of asthma symptoms. It works similarly to albuterol but has a longer duration of action. Salmeterol is generally not recommended as the sole therapy for asthma during pregnancy due to limited safety data. While animal studies have shown adverse effects on fetal development, there are no adequate and well-controlled studies in pregnant women. Therefore, the risks versus benefits of using salmeterol during pregnancy should be carefully considered, and alternative treatments may be preferred.

D. Prednisone:

Prednisone is a corticosteroid medication used to reduce inflammation and suppress immune responses in conditions such as asthma. It is often prescribed to manage asthma exacerbations during pregnancy. While corticosteroids are generally considered safe for short-term use during pregnancy to control asthma symptoms, they may have risks associated with long-term or high-dose use, especially if used during the first trimester. Potential risks include fetal growth restriction and cleft palate. However, the benefits of controlling asthma symptoms and preventing exacerbations often outweigh the potential risks of corticosteroid use during pregnancy. Therefore, prednisone may be prescribed judiciously during pregnancy, and the dose should be tailored to the individual's needs while considering potential risks to the fetus.

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Correct Answer is D

Explanation

A. Developing most often in women in their 30s:

Stress incontinence can affect women of various ages, not specifically those in their 30s. While childbirth and hormonal changes associated with aging can increase the risk of stress incontinence, it is not limited to any particular age group.

B. Feeling a strong need to void:

This characteristic is more indicative of urgency incontinence, also known as overactive bladder (OAB), where there is a sudden, strong urge to urinate that is difficult to control. It is different from stress incontinence, which is triggered by physical movements or activities that increase pressure on the bladder.

C. Passing a large amount of urine:

This choice does not specifically describe a characteristic of stress incontinence. Stress incontinence involves the leakage of small amounts of urine during activities such as coughing, sneezing, laughing, or exercising, rather than the passage of a large amount of urine at once.

D. Sneezing as an initiating stimulus:

This is the correct characteristic of stress incontinence. Stress incontinence is characterized by the leakage of urine during physical activities or movements that increase intra-abdominal pressure, such as coughing, sneezing, laughing, lifting, or exercising. Sneezing is a common initiating stimulus for stress incontinence episodes.

A. social isolation related to feelings about appearance B. ineffective peripheral tissue perfusion related to effects of disease on vasculature C. risk for suicide related to effects of condition and fluctuating hormone levels D. situational low self-esteem related to masculinization effects of the disease

Correct Answer is D

Explanation

A. Social isolation related to feelings about appearance:

Social isolation refers to a state in which an individual lacks social interaction or feels disconnected from others. This can occur when individuals feel self-conscious or ashamed about their appearance and may withdraw from social situations as a result. In this scenario, the woman's feelings about her appearance may indeed lead to social isolation. However, while social isolation is a significant concern, it may not be the most immediate priority compared to addressing the woman's feelings of low self-esteem.

B. Ineffective peripheral tissue perfusion related to effects of disease on vasculature:

Ineffective peripheral tissue perfusion refers to inadequate blood flow to the peripheral tissues, which can lead to impaired tissue oxygenation and nutritional deficits. While PCOS can have metabolic and cardiovascular implications, such as insulin resistance and dyslipidemia, leading to potential vascular issues, there is no indication in the scenario provided that the woman is experiencing acute vascular compromise. Therefore, this nursing diagnosis is less relevant in this context.

C. Risk for suicide related to effects of condition and fluctuating hormone levels:

PCOS is associated with an increased risk of mental health issues, including depression and anxiety, which can contribute to an elevated risk of suicidal ideation or behavior. The woman's distress over the physical manifestations of PCOS and feelings of diminished femininity could certainly exacerbate such psychological issues. However, while suicide risk is a serious concern, there is no explicit indication in the scenario that the woman is actively expressing suicidal thoughts or behaviors. Therefore, while it's important to monitor for signs of depression and suicidal ideation, this nursing diagnosis may not be the most immediate priority at this stage.

D. Situational low self-esteem related to masculinization effects of the disease:

This nursing diagnosis addresses the woman's feelings of low self-esteem specifically related to the physical manifestations of PCOS, such as hirsutism, alopecia, breast atrophy, and increased muscle mass, which are affecting her sense of femininity and self-identity. Given her distress and negative perception of her appearance, addressing her low self-esteem and providing support and interventions to help improve her self-image would likely be the most immediate priority in her care.

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A woman with a history of asthma comes to the clinic for evaluation for pregnancy. The woman's pregnancy test is positive. When reviewing the woman's medication therapy regimen for asthma, which medication would the nurse identify as problematic for the woman now that she is pregnant?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After teaching a local woman's group about incontinence, the nurse determines that the teaching was successful when the group identifies which characteristic of stress incontinence?

Correct Answer is D

Explanation

Correct Answer is D

Explanation

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