Which patient(s) would be able to take an alpha-adrenergic decongestant safely? (SELECT ALL THAT APPLY)

Correct Answers:

A. Frequent oral hygiene is necessary:Steroid inhalers can increase the risk of oral thrush and other infections, so maintaining good oral hygiene is essential to minimize this risk.

C. Rinse and spit after inhalation of the medication:Rinsing the mouth and spitting after using a steroid inhaler helps to remove residual medication and reduce the risk of developing oral thrush.

D. When taking a steroid drug as well as a bronchodilator, the bronchodilator should be administered first:Administering a bronchodilator first helps open the airways, allowing the steroid medication to reach deeper into the lungs for more effective treatment.

E. Hold your breath for 10 seconds during inhalation of the medication:Holding the breath allows for better medication absorption in the lungs.

Incorrect Answer:

B. The inhaler should be used on a PRN basis only:Steroid inhalers are typically used on a regular schedule for long-term control of asthma or other respiratory conditions, rather than on a PRN (as needed) basis. PRN use is more applicable to rescue inhalers, like short-acting bronchodilators.

A. Lower oxygen saturations of 93% to 94%

In an older adult client with a pneumothorax, the nurse could expect to observe lower oxygen saturations of 93% to 94%. A pneumothorax involves the accumulation of air in the pleural space, which can compress the lung and impair gas exchange, leading to hypoxemia (low blood oxygen levels). Decreased oxygen saturations would be a common finding in this condition.

B. Higher oxygen saturations of 98% to 99%

Higher oxygen saturations would be less likely in a client with a pneumothorax due to impaired gas exchange resulting from lung compression. Oxygen saturations are more likely to be lower in this condition, as indicated in option A.

C. Lower energy expenditure

While a pneumothorax may cause discomfort and dyspnea, which could potentially decrease energy expenditure due to reduced activity levels, it is not a direct physiological effect of the condition. Energy expenditure would depend on various factors, including the severity of symptoms and the individual's overall health status.

D. Increased lung capacity

A pneumothorax typically results in a decrease in lung capacity rather than an increase. The accumulation of air in the pleural space causes partial or complete collapse of the affected lung, reducing its ability to expand and decreasing overall lung capacity. Therefore, increased lung capacity would not be expected in a client with a pneumothorax.