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Drugs Used to Treat Lower Respiratory Disease > Pharmacology
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Showing 20 questions, Sign in for moreA patient with severe COPD arrived at the flu clinic to receive the annual influenza vaccination. The nurse noted that the patient had difficulty talking with frequent pauses between words to take a breath, was difficult to understand and appeared dyspneic and uncomfortable.
During the respiratory assessment of the patient in the scenario who was admitted to the hospital, the nurse noted the patient was coughing frequently and appeared to have difficulty beathing.
Which of the following should be included in the respiratory assessment? Select all that apply
During the evaluation of the patient in the scenario who was admitted to the hospital complaining of shortness of breath and increased sputum production, the nurse asks the patient for further information by which of the following statements? Select all that apply
The nurse explained to the patient in the scenario how the various medications worked to provide symptomatic relief of COPD.
Indicate with an X the mechanism of action for each type of medication.
Explanation
Pulmonary medications are classified by distinct pharmacological actions to manage chronic airway congestion, excessive mucus production, and disruptive cough reflexes. Expectorants stimulate bronchial gland secretions to thin respiratory tract fluids, whereas mucolytic agents chemically split disulfide bonds in purulent sputum. Conversely, antitussives suppress the medullary cough center or numb peripheral stretch receptors to control non-productive coughing episodes. Therapeutic goals focus on optimizing mucociliary clearance while preventing severe bronchospasm, mucous plugging, and respiratory fatigue in compromised patients.
Rationale for correct answers
1. Expectorants function by stimulating bronchial gland secretions within the respiratory mucosal lining. This pharmacological action increases the volume of fluid output while reducing the overall viscosity of tract secretions. Therefore, this mechanism accurately matches the therapeutic profile of standard expectorant agents. Consequently, patients experience more productive coughing that clears airway passages.
2. Expectorants actively hydrate respiratory secretions to facilitate easier mobilization and expulsion of trapped mucus. By adding water content to pulmonary mucus, these compounds reduce adhesiveness and tenacity along airway walls. Thus, this physiological mechanism correctly corresponds to expectorant drug classifications. This process ensures effective clearance of lower respiratory tract debris.
3. Mucolytic agents dissolve thick, sticky mucus by breaking down molecular disulfide bonds within abnormal mucoprotein networks. This direct chemical cleavage significantly reduces sputum viscosity and transforms gelatinous secretions into watery fluids. Therefore, this action accurately defines the primary mechanism of dedicated mucolytic medications. This intervention prevents complete airway obstruction from tenacious plugs.
4. Antitussives numb respiratory stretch receptors located throughout the pulmonary tree to interrupt the afferent neural pathway of coughing. By blocking peripheral sensory signals before they reach higher centers, these agents decrease reflex irritation. Thus, this specific action correctly describes peripheral antitussive drug mechanisms. This strategy provides effective relief from persistent dry coughs.
5. Antitussives suppress the medullary cough center located within the brainstem to inhibit the efferent motor response. This central nervous system depression raises the sensory threshold required to trigger a cough reflex. Therefore, this pharmacological activity correctly identifies central antitussive medications. Consequently, patients obtain relief from exhausting, non-productive coughing spasms.
Test-taking strategy
- Analyze the Medication Categories: Review the distinct physiological mechanisms defining expectorants, mucolytics, and antitussives.
- Evaluate Each Mechanism and Drug Class:
- Rule in Expectorants for stimulating bronchial gland secretions and hydrating respiratory secretions.
- Rule in Mucolytic Agents for dissolving thick, sticky mucus via disulfide bond cleavage.
- Rule in Antitussives for numbing respiratory stretch receptors and suppressing the brainstem cough center.
- Rule out mismatched classifications that attribute secretory stimulation to mucolytics or cough suppression to expectorants.
- Match Actions to Categories: Ensure each pharmacological property aligns precisely with the intended therapeutic drug classification.
Take home points
Expectorants stimulate and hydrate respiratory tract secretions to facilitate productive mucus clearance.
Mucolytic agents chemically break down thick, sticky sputum by cleaving molecular disulfide bonds.
Peripheral antitussives numb respiratory stretch receptors to interrupt afferent coughing reflex pathways.
Central antitussives suppress the medullary cough center in the brain to control non-productive coughing.
The nurse is preparing to administer the beta-adrenergic bronchodilator albuterol but firstrst performs which of the following preassessments on the patient? Select all that apply
The nurse instructing the patient in the scenario on the drug tiotropium bromide (Spiriva), which was being started instead of continuing ipratropium bromide (Atrovent), realized further teaching was needed after the patient made which statement?
The nurse instructing a patient on the corticosteroid inhalant budesonide (Pulmicort) realized further teaching was needed after the patient made which statement?
A nurse is providing instructions to a client who has been prescribed albuterol (Proventil) and beclomethasone (QVAR) inhalers for the control of asthma. Which of the following should the nurse include in the teaching?
A client with asthma has a prescription for two inhalers, albuterol (Proventil, VoSpire) and beclomethasone (Qvar). How should the nurse instruct this client on the proper use of the inhalers?
An Advair Diskus, fluticasone propionate (Flonase) and salmeterol (Serevent) 100 mcg/50 mcg, is ordered for a patient with COPD. What does the nurse know about this medication? Select all that apply
The nurse is teaching a patient about the inhaler Advair (fluticasone/salmeterol). Which statements by the patient indicate a correct understanding of this medication? Select all that apply
A client with asthma is prescribed albuterol. Which finding indicates that the medication is producing the intended therapeutic effect?
The nurse is comparing short-acting and long-acting beta2 agonists. Which statement is accurate?
A client receiving albuterol reports palpitations and tremors. Which pharmacologic effect most likely explains these findings?
The nurse is reviewing a prescription for a client receiving an inhaled anticholinergic. Which condition requires particular caution?
Which adverse effect is most characteristic of inhaled anticholinergic bronchodilators?
The nurse is caring for a client receiving theophylline. Which finding is most concerning for theophylline toxicity?
Which statement best describes why theophylline requires careful monitoring?
The nurse is reviewing medications that may increase theophylline concentrations. Which medications should the nurse identify as potential interactions? Select all that apply
Which of the following pairing of medication and mechanism of action is accurate?
The nurse is prioritizing care for four clients receiving medications for lower respiratory disorders. Which finding requires the most immediate intervention?
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