The nurse is instructing a client with allergic rhinitis about the correct technique for using an intranasal inhaler. Which instruction is most important for the nurse to provide the client?

Hold one nostril closed while spraying the other nostril.

Use the inhaler when first awakening in the morning.

Avoid shaking the inhaler immediately before using

Angle the tip of the inhaler upward while spraying.

Answer and Explanation

The Correct Answer is A

A. Hold one nostril closed while spraying the other nostril: Closing one nostril while administering the spray ensures the medication is delivered more effectively into the nasal passages, allowing for better absorption and symptom control by maximizing the contact of the medication with the nasal mucosa.

B. Use the inhaler when first awakening in the morning: The specific timing of intranasal corticosteroid use may vary depending on the healthcare provider's instructions and the client's symptom pattern. While morning use can be beneficial due to peak allergy symptoms, it is not the most critical technique instruction. Proper administration ensures better drug efficacy regardless of timing.

C. Avoid shaking the inhaler immediately before using: Some nasal sprays, especially suspensions, require shaking to evenly distribute the medication. Advising not to shake could lead to inconsistent dosing and reduced effectiveness, depending on the specific medication.

D. Angle the tip of the inhaler upward while spraying: The inhaler tip should be angled slightly outward toward the ear, not straight upward, to target the correct nasal structures. Spraying directly upward could lead to discomfort or less effective drug delivery.

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Free Nursing Study Resources

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"C"},"E":{"answers":"C"}}

Explanation

Blood glucose 218 mg/dL (12.1 mmol/L)

Classification: Unrelated Finding
Rationale: Minoxidil does not influence blood glucose levels. This elevated blood glucose is likely related to the patient’s known history of type 2 diabetes mellitus. It's not a side effect or intended therapeutic action of minoxidil.

Dizziness while sitting up

Classification: Nontherapeutic Side Effect
Rationale: Minoxidil is a vasodilator that can cause a rapid drop in blood pressure, particularly when changing positions (orthostatic hypotension). Dizziness is a common side effect due to decreased cerebral perfusion when blood pressure drops too quickly or too much.

Blood pressure 162/111 mm Hg

Classification: Therapeutic Result
Rationale: On admission, the patient’s BP was dangerously high at 203/166 mm Hg. A subsequent reading of 162/111 mm Hg shows a significant drop, indicating that minoxidil is having the desired therapeutic effect of lowering blood pressure, even though it's still above target.

Pain rated at 1 on a 0 to 10 scale

Classification: Unrelated Finding
Rationale: Minoxidil is not a pain medication and does not impact pain perception. A low pain score of 1 is likely due to an unrelated mild discomfort or pre-existing condition and has no connection to minoxidil's effects.

Urine output 600 mL

Classification: Unrelated Finding
Rationale: Minoxidil may cause fluid retention, but 600 mL urine output is within the normal range over a few hours (depending on timing and context). This measurement alone does not indicate a therapeutic or side effect of the drug, and without signs of oliguria or diuresis, it remains unrelated.

A. Assess the client's vital signs. B. Review the client's culture and sensitivity reports. C. Implement neutropenic precautions. D. Inform the client that the medication has been effective.

Correct Answer is D

Explanation

A. Assess the client's vital signs: While it is always important to monitor vital signs, the increase in white blood cell (WBC) count indicates a positive response to filgrastim, and there is no immediate concern requiring urgent vital sign assessment based on the WBC count alone.

B. Review the client's culture and sensitivity reports: Reviewing culture reports is necessary when managing an active infection, but the question does not indicate the client currently has an infection. The focus here is evaluating the medication's effectiveness.

C. Implement neutropenic precautions: Neutropenic precautions are necessary when the WBC count is critically low. Since the client's WBC has improved into the low-normal range, these precautions are no longer necessary.

D. Inform the client that the medication has been effective: Filgrastim is used to stimulate WBC production. The client's WBC count has increased to the normal range after five doses, demonstrating that the medication is working effectively as intended.

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The nurse is instructing a client with allergic rhinitis about the correct technique for using an intranasal inhaler. Which instruction is most important for the nurse to provide the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Patient Data Exhibits Click to mark whether the assessment finding represents a therapeutic result of the minoxidil administered, a nontherapeutic side effect, or an unrelated finding. Each row must have one option selected.

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"C"},"E":{"answers":"C"}}

Explanation

After receiving five doses of filgrastim, the nurse notes that the client's white blood cell count has increased from 2,500/mm3 (2.5 x 10 /L) to 5,000/mm3 (5 x 105/L). Which action should the nurse implement?Reference Range:White Blood Cell (WBC) [5,000 to 10,000/mm3 (5 to 10 x 109/L)]

Correct Answer is D

Explanation

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