Summary
Summary NURS 615 Exam 4 Review Sheet
- Course
- Nur 615
- Institution
- Maryville University Of St. Louis
This is a comprehensive and detailed study guide on Exam 4 for Nurs 615. ***An Essential Study Resource!!
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Exam 4 Review Sheet1. What is a SABA used to treat?
Short-acting Beta agonist Bronchodilators used to treat bronchospasms due to
COPD, asthma attacks, and bronchitis
-Asthma, COPD (emphysema, chronic bronchitis associated with smoking
history)
-Can be used for prophylaxis and allergen induced asthma attacks—beta 2
agonist only treating the bronchospasms; not the underlying inflammatory
response
-Can be used for exercise-induced asthma (10 minis prior to exercise and as
needed afterwards)
**If patient is having bronchospasm, and is on a beta blocker (non-specific
beta blocker) will need to be bronchodilated in a different way—use an
antimuscrinic or anticholinergic/cholingeric blocker agent** (i.e.
ipratropium)
2. What are the adverse effects associated with montelukast (Singular)?
HA, nervousness, GI upset, dizziness, fatigue, sore throat, fever, and nasal
congestion
- (i.e. zafirlukast) Is a leukotriene receptor antagonist—blocks
amplifying inflammatory process
- Usually well tolerated, but any side effects usually dissipate after the
first few weeks of therapy—Montelukast—warnings about
depression/suicidal ideation
- Adverse effects: Agitation, anxiousness, restless, insomnia, tremors,
anaphylaxis, angioedema, muscle weakness, & elevated AST/ALTs
3. What patient teaching should accompany the prescription of montelukast
(Singulair)?
Medication should be taken as prescribed, even in the absence of symptoms, use
bronchodilators for acute episodes of bronchospasms, not to be taken if pregnant
or nursing, can be taken at anytime of the day, monitor respiratory status (i.e.
spirometer), avoid environmental triggers to asthma, no smoking.
, -Caution about Suicidal Ideation/Suicide attempts, must be taken at the same
time everyday, it is a controlling medication, not as needed medication
-Caution is advised in pregnancy/lactation, patient should know how to take
the drug, what to do when missed a dose, therapy goals, follow-up, report
any new medications, understand disease management principles, avoid
triggers to allergic reactions, must be taken on an empty stomach, know what
can be handled at home and when to call healthcare provider
4. What patient teaching should be provided when prescribing inhaled
corticosteroids?
Use the inhaled bronchodilator first, wait a few minutes then use the inhaled
corticosteroids, while inhaling, press down on canister, breath in deeply and
slowly, hold breath for 10 secs. Wait 1 minute between doses, rinse mouth after
each use, therapeutic effects may take up to 3-7days.
-Are not rescue medications!! Are control medications, work to prevent
problems and address underlying pathophysiology they are treating, need to
be used regularly, everyday, patient should know how to use the inhaler
-Adverse effects: Dysphonia (funny sound to voice), hoarseness, cough, dry
mouth, candidiasis (fungal infection)
5. What is the mechanism of action of albuterol?
Albuterol acts on beta-2 adrenergic receptors to relax the bronchial smooth
muscle. Stimulation of receptors in vascular smooth muscle leads to vasodilation,
a decrease in dystolic pressure, and a reflex increase in heart rate.
-Binds to beta 2 receptors in the lungs-induce bronchodilation, increases
cyclic amp causes relaxation of muscle in bronchial tree, helps decrease the
mediators to hypersensitivity reactions (mostly happens in mast cells).
6. What is the mechanism of action of inhaled corticosteroids?
Inhibit inflammatory cells (IgE and mast cells) from migrating into bronchial
tissues
-If inhaled corticosteroids suddenly stopped, than can experience adrenal
insufficiency, if patient been on prednisone, need to taper off slowly when
switching to inhaled (if been on prednisone for more than 3 weeks)
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