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 A
Explanation
Choice A Reason:
Use a straw to ingest: Ferrous sulfate elixir can cause staining of the teeth. Using a straw helps to minimize contact with the teeth, thereby reducing the risk of staining. This method ensures that the medication is ingested directly into the throat, bypassing the teeth.
Choice B Reason:
Swallow undiluted: Swallowing ferrous sulfate elixir undiluted is not recommended because it can cause gastrointestinal irritation. Diluting the elixir in water or juice can help to minimize this irritation and improve absorption.
Choice C Reason:
Mix with an antacid: Mixing ferrous sulfate with an antacid is not advisable because antacids can interfere with the absorption of iron. Iron is best absorbed in an acidic environment, and antacids neutralize stomach acid, thereby reducing iron absorption.
Choice D Reason:
Take with a glass of milk: Taking ferrous sulfate with milk is not recommended because calcium in milk can inhibit the absorption of iron. It is best to take iron supplements on an empty stomach or with a source of vitamin C, such as orange juice, to enhance absorption
Correct Answer is D
Explanation
Choice A reason: A complete blood count (CBC) is not typically required before starting statin therapy. While a CBC can provide valuable information about a patient’s overall health, it does not specifically relate to the potential side effects or necessary monitoring for statin use. Statins primarily affect the liver, so monitoring liver function is more critical.
Choice B reason: Serum electrolytes are important for assessing overall metabolic and kidney function, but they are not directly related to the initiation of statin therapy. Statins do not typically affect electrolyte levels, so this test is not necessary before starting the medication.
Choice C reason: Capillary blood glucose levels are important for monitoring diabetes and blood sugar control. While statins can have an impact on blood glucose levels, this is not the primary concern when initiating therapy. Monitoring liver function is more directly related to the potential side effects of statins.
Choice D reason: Serum liver enzymes are crucial to review before starting statin therapy. Statins can cause liver enzyme elevations, indicating liver damage or dysfunction. Therefore, baseline liver enzyme levels should be obtained to monitor for any potential hepatotoxicity during treatment.
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