Management of asthma involves avoidance of triggers. Which environmental triggers will the nurse suggest the patient eliminate? Select all that apply.

(Select All that Apply.)

Cardiovascular exercise

Beta-blocking medications

Exposure to secondhand smoke

Carpet and drapes in the bedroom

Pets and foods that cause symptoms

Answer and Explanation

Correct Answer : B,C,D,E

B. Beta-blocking medications, such as propranolol and metoprolol, can worsen asthma symptoms in some individuals by constricting the airways. Patients with asthma should avoid or use caution with beta-blockers, especially non-selective ones, as they can trigger or exacerbate asthma attacks.
C. Exposure to secondhand smoke is a well-established trigger for asthma symptoms and can exacerbate respiratory inflammation and airway hyperresponsiveness. Patients with asthma should avoid exposure to secondhand smoke whenever possible to reduce the risk of asthma exacerbations.
D. Carpeting and drapes can harbor dust mites, pet dander, and other allergens that can trigger asthma symptoms in susceptible individuals. Patients with asthma may benefit from removing carpeting and minimizing soft furnishings in the bedroom to reduce exposure to allergens and improve air quality.
E. Pets, particularly those with fur or feathers, can be potent allergens for individuals with asthma. Patients with asthma should consider removing pets from the home or at least keeping them out of the bedroom to minimize exposure to pet dander.
A. Cardiovascular exercise can trigger asthma symptoms in some individuals but it is not typically recommended to eliminate exercise altogether. Instead, patients with asthma should be encouraged to engage in physical activities that are well-tolerated and to use appropriate preventive measures, such as pre-exercise bronchodilator therapy and warm-up exercises, to minimize symptoms.

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Correct Answer is B

Explanation

B. Expiratory wheezes are high-pitched, musical sounds produced by air passing through narrowed or obstructed airways. Wheezing is a hallmark sign of asthma, particularly during an exacerbation, and is usually more pronounced during expiration due to the increased effort required to expel air through the narrowed airways.
A. A pleural friction rub is a grating sound produced by the movement of inflamed pleural surfaces rubbing together. It is typically heard in conditions such as pleuritis (inflammation of the pleura) or pleurisy. This sound is not commonly associated with asthma exacerbations.
C. Rhonchi are low-pitched, snoring-like sounds that occur due to the presence of mucus or other secretions in the larger airways. While rhonchi can be heard in conditions with increased mucus production, such as bronchitis, they are not typically the primary sound associated with asthma exacerbations.
D. Fine rales, also known as crackles, are high-pitched, popping sounds heard during inspiration. They are usually associated with conditions involving fluid in the alveoli, such as pulmonary edema or interstitial lung disease. Crackles are not characteristic of asthma.

A. "I can have 6 ounces of alcohol before bed, to help me sleep." B. "I will sleep on my stomach with my head flat." C. "I should elevate the head of the bed." D. "I will have a snack 1 hour before going to bed."

Correct Answer is C

Explanation

C. Elevating the head of the bed can help reduce nighttime GERD symptoms. By elevating the head of the bed by about 6 to 8 inches (15 to 20 centimeters), gravity helps prevent stomach acid from refluxing into the esophagus while the individual is lying down. This position can alleviate symptoms such as heartburn, regurgitation, and coughing during sleep.
A. Alcohol consumption, especially before bedtime, can exacerbate GERD symptoms. Alcohol relaxes the lower esophageal sphincter (LES), allowing stomach acid to reflux into the esophagus more easily.
B. Sleeping on the stomach with the head flat can worsen GERD symptoms. This position can increase pressure on the stomach and promote reflux of stomach acid into the esophagus. Sleeping on the stomach is generally not recommended for individuals with GERD.
D. Eating a large meal or having a snack shortly before bedtime can increase the likelihood of GERD symptoms during sleep. It's generally recommended to avoid eating large meals or heavy snacks close to bedtime. Instead, individuals with GERD should aim to finish eating at least 2 to 3 hours before lying down to sleep.

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Management of asthma involves avoidance of triggers. Which environmental triggers will the nurse suggest the patient eliminate? Select all that apply. (Select All that Apply.)

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Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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Management of asthma involves avoidance of triggers. Which environmental triggers will the nurse suggest the patient eliminate? Select all that apply.

(Select All that Apply.)