In providing care to a patient admitted with an acute asthma exacerbation, the nurse prepares which "rescue" medication for administration first?

Long-acting beta2-adrenergic agonists

Short-acting beta2-adrenergic agonists

Mucolytic

Inhaled anti-inflammatories

Answer and Explanation

The Correct Answer is B

A.   Long-acting beta2-adrenergic agonists (LABAs) are used for the maintenance treatment of asthma but are not suitable for immediate relief during an acute exacerbation. They take longer to take effect and are used as part of a long-term management plan rather than a rescue plan.
B.   Short-acting beta2-adrenergic agonists (SABAs), such as albuterol, are the first-line treatment for acute asthma exacerbations. They work quickly to relax the muscles around the airways, providing immediate relief of bronchospasm and improving airflow. This is why they are referred to as "rescue" medications.
C.   Mucolytics are used to thin and loosen mucus in the airways, which can be helpful for conditions involving thick mucus. However, they are not used for immediate relief of asthma symptoms and do not address bronchospasm directly. They are not appropriate as a first-line treatment in an acute asthma attack.
D.   Inhaled corticosteroids are used for long-term control of asthma by reducing inflammation in the airways. While they are important for ongoing management, they do not provide immediate relief during an acute asthma exacerbation and should not be used as rescue medication.

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Correct Answer is ["A","B","D","E"]

Explanation

A. Rinsing the mouth and spitting after using a steroid inhaler is essential to prevent oral thrush, a common side effect of inhaled corticosteroids. This practice helps clear residual medication from the mouth and throat, reducing the risk of fungal infections.
B. Bronchodilators, such as short-acting beta-agonists (SABAs), should be used before steroid inhalers. The bronchodilator opens the airways, allowing the steroid to reach deeper into the lungs for better efficacy.
C. While some inhalers (like rescue inhalers) may be used on a PRN basis, steroid inhalers are typically prescribed for regular, daily use to manage inflammation and control chronic conditions like asthma or COPD. They are not intended for PRN use only.
D. Frequent oral hygiene helps to reduce the risk of oral thrush and other oral health issues associated with steroid use. Patients should be encouraged to maintain good oral hygiene practices while using inhaled steroids.
E. Holding the breath for about 10 seconds after inhalation allows for better medication absorption in the lungs. This practice helps maximize the efficacy of the inhaled medication.

A. Patient color B. Lung sounds C. Heart tones D. Bowel sounds E. Peripheral pulses F. Respiratory rate and effort G. Pulse oximetry reading H. Peak expiratory flow

Correct Answer is ["A","B","C","F","G","H"]

Explanation

A. The patient's color can indicate their oxygenation status. Cyanosis (bluish tint) may suggest hypoxia, which is critical to assess in an asthma patient.
B. Auscultation of lung sounds is essential in asthma assessment. The presence of wheezing, prolonged expiration, or decreased breath sounds can indicate airway obstruction and the severity of the asthma exacerbation.
C. Assessing heart tones can provide information about the cardiovascular response to respiratory distress. Increased heart rate may occur due to hypoxia or anxiety associated with asthma attacks.
D. Bowel sounds are not relevant in the assessment of asthma. While gastrointestinal symptoms may co- occur in some patients, they are not directly related to asthma's respiratory condition.
E. While peripheral pulses are important in general assessments, they do not provide specific information relevant to asthma management or respiratory status.
F. Monitoring respiratory rate and effort is crucial in assessing asthma. Increased respiratory rate and use of accessory muscles may indicate respiratory distress or an asthma exacerbation.
G. A pulse oximetry reading provides an objective measure of oxygen saturation. Low oxygen saturation levels indicate inadequate oxygenation, which is critical to monitor in asthma patients.
H. Measuring peak expiratory flow rate (PEFR) helps assess the severity of airway obstruction and monitor asthma control. It can guide treatment decisions and determine if an asthma attack is occurring.

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In providing care to a patient admitted with an acute asthma exacerbation, the nurse prepares which "rescue" medication for administration first?

Nursing Test Bank

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