Pharmacology Adams/Holland Ch 40:
Drugs for Asthma and Other Pulmonary
Disorders
The client receives albuterol (Proventil) via inhaler. He asks the nurse why he can't just
take a pill. What is the best response by the nurse?
1. "When you inhale the drug the blood supply in your lungs picks it up rapidly, resulting
in quicker effects."
2. "Because pills cannot help your illness; you must have inhaled medications for relief
of symptoms."
3. "Because pills would produce too many side effects; you will have very few side
effects with inhaled medications."
4. "Because this medication cannot be absorbed from your GI tract; the acid in your
stomach would destroy it." - ANS-Correct Answer: 1
Rationale 1: The respiratory system offers a rapid and efficient mechanism for delivering
drugs. The enormous surface area of the bronchioles and alveoli, and the rich blood
supply to these areas, results in an almost instantaneous onset of action for inhaled
substances.
Rationale 2: Albuterol (Proventil) can be given orally (PO) but has a faster onset of
action if inhaled.
Rationale 3: Inhaled medications also produce side effects.
Rationale 4: Oral medications are effective with some symptoms of respiratory
disorders, but inhaled medications work faster.
The nurse teaches a medication class on bronchodilators for clients with asthma. The
nurse evaluates that learning has occurred when the clients make which statement?
1. "The medication widens the airways because it decreases the production of mucus
that narrows them."
2. "The medication widens the airways because it decreases the production of
histamine that narrows them."
3. "The medication widens the airways because it acts on the parasympathetic nervous
system."
4. "The medication widens the airways because it stimulates the fight-or-flight response
of the nervous system." - ANS-Correct Answer: 4
Rationale 1: Bronchodilators do not decrease the production of mucus.
Rationale 2: Bronchodilators do not decrease the production of histamine.
, Rationale 3: Bronchodilators act on the sympathetic nervous system, not the
parasympathetic nervous system.
Rationale 4: During the fight-or-flight response, beta2-adrenergic receptors of the
sympathetic nervous system are stimulated, the bronchiolar smooth muscle relaxes,
and bronchodilation occurs.
The client asks the nurse why she must continue taking her asthma medication even
though she has not had an asthma attack in several months. What is the best response
by the nurse?
1. "The medication needs to be taken indefinitely according to your doctor, so you
should discuss this with him."
2. "The medication is still needed to decrease inflammation in your airways and help
prevent an attack."
3. "The medication needs to be taken or your lungs will be severely damaged, and we
will not be able to stop an acute attack."
4. "The medication needs to be taken for at least a year; then, if you have not had an
acute attack, you can stop it." - ANS-Correct Answer: 2
Rationale 1: The nurse is able to answer the client's question; it does not need to be
referred to the physician.
Rationale 2: Effective treatment of asthma includes long-term treatment to prevent
attacks and decrease inflammation, as well as short-term treatment when an attack
occurs.
Rationale 3: Telling a client that his or her lungs will be severely damaged is
non-therapeutic; the inability to prevent an acute attack in this client is not true.
Rationale 4: Long-term treatment of asthma continues indefinitely, not for just 1 year.
The nurse plans to teach an adolescent about inhalation therapy as part of the
treatment plan for the client's asthma. What does the best plan by the nurse include?
1. Inhalation therapy is effective because it provides around-the-clock therapy, as
opposed to oral medications.
2. Inhalation therapy is the preferred treatment for adolescents because it is easier for
them to manage.
3. Inhalation therapy is effective because it provides systemic relief of symptoms as well
as local relief.
4. Inhalation therapy is effective because it goes to the direct site of action in the
respiratory tract. - ANS-Correct Answer: 4
Rationale 1: Inhalation therapy does not provide around-the-clock therapy.
Rationale 2: Inhalation therapy is used for adolescents because it is effective, not
because it is easier for them to manage.
Rationale 3: Inhalation therapy does not provide systemic relief of symptoms.
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