Jennifer Hoffman vsim post quiz
While caring for Ms. Hoffman, the nurse recognizes which of the following clinical manifestations
are indicative of an acute asthma attack? (Select all that apply.)
Cough, Wheezing, Dyspnea
Rationale:Cough is a classic manifestation of asthma; sometimes, it may be the only sign.
Wheezing is associated with turbulent airflow and small airway vibration in which there is partial
obstruction, which is what occurs physiologically in the lungs during an asthma attack. Stridor is
caused when turbulent air flows through a narrowed trachea or larynx, whereas asthma is a
lower respiratory disorder. Fine crackles are associated with bronchitis or pneumonia and are
discontinuous popping sounds heard in late inspiration; they originate in the alveoli. Dyspnea is
shortness of breath, which indicates the client is having difficulty breathing. Rhonchi are
low-pitched gurgling sounds produced by secretions within the larger airway; they are not
representative of airway obstruction.
After Ms. Hoffman's asthma attack resolves, the nurse asks to review her current medications.
During the discussion, Ms. Hoffman shares that she took asthma medication, but it did not help.
The nurse recognizes that Ms. Hoffman may have used the incorrect medication to relieve the
symptoms of an asthma attack. The nurse should include which of the following as rescue
medications to take at the beginning of an asthma attack? (Select all that apply.)
Albuterol, Ipratropium, Levalbuterol
Rationale:Albuterol and levalbuterol are classified as short-acting beta 2 agonists, which means
they provide relief of acute symptoms through bronchodilation. They bind to the beta 2
adrenergic receptor, which produces smooth muscle relaxation and decreases
bronchoconstriction. Ipratropium is indicated for relief of acute bronchospasm because it
induces bronchodilatation through inhibition of muscarinic cholinergic receptors. Formoterol and
salmeterol are long-acting beta 2 agonists that are given to prevent symptoms of asthma and
are inappropriate to be given in an emergency situation. In an asthma attack, a quick-acting
inhaler should be used. There have been asthma deaths related to clients using a long-acting
beta 2 agonist instead of a short-acting beta 2 agonist. Budesonide is an inhaled corticosteroid
given for long-term prevention of symptoms and suppression, control, and reversal of
inflammation. It does not have a quick action; therefore, it would not be used to terminate an
asthma attack.
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