NUR 311 Case Study Exam 2 Questions and Correct Answers
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Course
NUR 311
Institution
NUR 311
An 18-year-old college Freshman has had asthma since she was 5 years old. During the past year, she has had occasional asthma attacks and used an albuterol (Proventil) inhaler 2 to 4 times a week on an as needed (PRN) basis. As she tries to make the adjustment to college life and participate in all...
NUR 311 Case Study Exam 2 Questions
and Correct Answers
Case Study: Asthma
An 18-year-old college Freshman has had asthma since she was 5 years old. During
the past year, she has had occasional asthma attacks and used an albuterol (Proventil)
inhaler 2 to 4 times a week on an as needed (PRN) basis. As she tries to make the
adjustment to college life and participate in all the various activities, her attacks begin to
occur more frequently, and she has had to use her albuterol inhaler once or twice a day.
She comes to the student health center for management of her asthma.
1. What information would be helpful for the nurse to obtain before the student is seen
by the nurse practitioner? ✅Medical history including dysrhythmias, diabetes,
hypertension, hyperthyroidism, and
heart disease
Vital signs & knowledge and current assessment of PEFR and "zone" system
Have patient demonstrate technique used for administration of albuterol using a
demonstrator MDI.
2. The nurse practitioner prescribes cromolyn (Intal) 3 puffs, 10 minutes apart, 3 times a
day and montelukast (Singulair) 10 mg by mouth once a day. She is instructed that she
may use her albuterol inhaler 2 puffs, every 4 hours as needed if asthma symptoms are
present. The patient questions why cromolyn has been prescribed. What should the
nurse include in the explanation? ✅Cromolyn prevents mast cells from lysing and
releasing histamine and other pro-inflammatory mediators. It can prevent episodes
when taken regularly or before allergen exposure or exercise. Some asthma is believed
to be a response to allergens causing inflammation and bronchospasm. Inflammation
can permanently damage the cells lining the airway. Inflammation triggers bronchial
hyperreactivity, making the airway more prone to constriction. Preventing inflammation
decreases airway damage and constriction.
3. The patient returns to the health center for follow-up care. She is still using her
albuterol inhaler several times a day and is discouraged that her asthma is still "out of
control." The NP discontinues the cromolyn and montelukast and prescribes
budesonide and formoterol (Symbicort) 2 puffs every 12 hours as her regular
medication regimen in addition to the PRN albuterol. The student asks the nurse what
the difference is between the Symbicort and albuterol if they are both bronchodilators.
How should the nurse respond? ✅Albuterol is fast-acting and can treat current
bronchoconstriction.
Symbicort is long-acting and should be taken regularly to prevent symptoms, but it is
not appropriate for treating existing symptoms.
, 4. What teaching should the nurse provide about administration of the prescribed
drugs? ✅If albuterol is needed at the time the other drug is due, administer it first and
wait 3
to 5 minutes before using the Symbicort so it starts bronchodilation, and the other
drug will go deeper into the lungs.
Consider gargling with water after administration of Symbicort in an attempt to
reduce fungal infections of the mouth.
A spacer is not necessary with albuterol HFA or Symbicort.
5. The nurse knows that many college students study before exams for long periods at
a time. Colas, coffee, and over-the-counter drugs containing caffeine are commonly
used to prevent drowsiness. How should the nurse use this knowledge? ✅Address the
difficulties of preparing for major examinations and projects. Help or
refer the student so that she can learn effective time management and study
techniques.
Explain the dangers of the stimulation of bronchodilators combined with caffeine.
Teach the student to seek medical care if she experiences chest pain, palpitations, or
unexplained dizziness or fainting.
Case Study: Peptic Ulcer Disease
You have been assigned to care for Mr. P, a 44-year-old male recently diagnosed with
peptic ulcer disease. He has a 15 pack-year history of smoking cigarettes and takes
ibuprofen (Motrin) regularly for an old football injury to his knee. He has been prescribed
cimetidine. You are teaching him how to manage his peptic ulcer disease and other
conditions.
1. Mr. P says, "When I take an antacid, like Rolaids, I feel better. Why can't I take
antacids anymore? That's what the doctor told me." What is your best response? ✅
2. He states, "I have a headache, and my knee hurts. I need an aspirin or a Motrin."
What is your best response? ✅
3. Mr. P asks, "What can you tell me about the negative effects of this pill, cimetidine?"
What is your best response? ✅
Pharmacology for Nursing Practice: NUR 311
Rosa is a 13-year-old female who has been complaining to her mother of being thirsty
all the time and that her teachers will not let her use the bathroom frequently at school.
After Rosa's mother has had to pick her up at the health office for several days in a row,
she takes Rosa to the pediatrician.
Rosa's current vital signs are blood pressure (BP) 138/88 mm Hg, heart rate (HR) 80
beats/min, and respiratory rate (RR) 18 breaths/min; she is afebrile. She weighs 161
pounds, and her height is 5 feet, 4 inches. Rosa's body mass index is 28.7.
Her physician orders blood work and she is to return for follow up in 1 week. The
results of her laboratory results are as follows (normal values in parentheses):
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