A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?
Rinses the mouth after each use.
Stores the medication at room temperature.
Attaches a spacer device to the inhaler.
Primes the inhaler with 7 pumps.
The Correct Answer is D
Choice A reason:
Rinsing the mouth after each use of an inhaler is a recommended practice, especially for inhalers containing corticosteroids, to prevent oral thrush and other side effects. Although ipratropium is not a corticosteroid, rinsing the mouth can still help reduce any potential irritation or unpleasant taste.
Choice B reason:
Storing the medication at room temperature is appropriate for most inhalers, including ipratropium2. This ensures the medication remains effective and safe to use. It is important to keep the inhaler away from extreme temperatures and direct sunlight.
Choice C reason:
Attaching a spacer device to the inhaler can be beneficial, especially for patients who have difficulty coordinating the timing of inhalation with the activation of the inhaler. A spacer helps ensure that more medication reaches the lungs rather than being deposited in the mouth or throat.
Choice D reason:
Priming the inhaler with 7 pumps is excessive. Typically, ipratropium inhalers require priming with only 2 to 4 sprays before the first use or if the inhaler has not been used for a few days. Over-priming can waste medication and may indicate that the client needs additional instruction on proper inhaler use.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: While it is true that breastfeeding is not recommended while taking isotretinoin due to the potential for adverse effects on the infant, this is not the most critical information for a client planning to become pregnant. The primary concern is the teratogenic effects of isotretinoin, which can cause severe birth defects.
Choice B reason: Advising the client not to take multiple vitamins that contain vitamin A while on isotretinoin is important because excessive vitamin A can increase the risk of toxicity. However, this is not the most crucial information for someone planning to become pregnant. The teratogenic risks of isotretinoin are a higher priority.
Choice C reason: Obtaining baseline liver function results is necessary during isotretinoin therapy due to the potential for hepatotoxicity. Regular monitoring helps ensure the liver is functioning properly. However, this information is secondary to the need to avoid pregnancy while on isotretinoin due to its severe teratogenic effects.
Choice D reason: Discontinuing isotretinoin one month before attempting to conceive is the most important information. Isotretinoin is highly teratogenic and can cause serious birth defects. It is crucial to stop the medication well before conception to ensure it is completely cleared from the body, reducing the risk of harm to the fetus.
Correct Answer is B
Explanation
Choice A Reason:
Notifying the healthcare provider of the contraindication to tetracyclines is not necessary in this context. Doxycycline, a type of tetracycline, is commonly prescribed and does not have a direct contraindication with birth control pills. However, the nurse should be aware of potential interactions and advise the client accordingly.
Choice B Reason:
Advising the client that the birth control pills will be less effective while taking doxycycline hyclate is crucial. Antibiotics like doxycycline can reduce the effectiveness of hormonal contraceptives, increasing the risk of unintended pregnancy. The client should be informed about this interaction and advised to use an additional non-hormonal method of contraception, such as condoms, while taking the antibiotic and for a short period after completing the course.
Choice C Reason:
Instructing the client to take the two medications at least two hours apart is not relevant in this case. The interaction between doxycycline and birth control pills is not related to the timing of administration but rather to the potential reduction in the effectiveness of the contraceptive.
Choice D Reason:
Encouraging the client to stop taking birth control pills until she has finished taking all the doxycycline hyclate is not advisable. Stopping birth control pills can lead to a disruption in the contraceptive regimen and increase the risk of unintended pregnancy. Instead, the client should be advised to use an additional method of contraception.
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