5

Answer Key to Chapter 5

Section 5.15 Light Bulb Moment Case Study 1 (Asthma Scenario)

1. The correct answer is c) Albuterol. Albuterol is a Beta-2 agonist that relaxes smooth muscle to cause bronchodilation and assists the patient with the work of breathing. It is a rapid-acting bronchodilator that is used during asthma attacks.

2. The nurse should instruct the patient to take the following steps to safely administer albuterol:

• Insert the inhaler into the spacer and shake the canister
• Breathe out all the way
• Press down on the inhaler and breathe in slowly through the mouth
• Breathe in for 10 seconds or as long as you can tolerate
• Remove the inhaler from the mouth
• Wait 30 seconds between doses

3. After administering the medication, the nurse should assess the patient’s vital signs and lung sounds, paying special attention to the respiratory rate, pulse oximetry, and heart rate for signs of improvement, as well as for potential side effects such as tachycardia.

4. The nurse should educate the patient regarding the correct method to administer albuterol, potential side effects, and the signs and symptoms of an asthma exacerbation. The nurse should ensure the patient has a written copy of their asthma action plan and verify that the patient can explain the plan to ensure proper understanding. The nurse should also explain the importance of always having albuterol on hand and to help the patient make plans for refills so as to not run out of medication.

5. To ensure correct use of the inhaler, the nurse should ask the patient to provide a return demonstration.

You can review additional information about asthma in the “Diseases of the Respiratory System” section and albuterol in the “Beta-2 Agonists” section of this chapter.

Section 5.15 Light Bulb Moment Case Study 2 (Allergy Scenario)

1. The correct answer is b) Epinephrine. Epinephrine is used to rapidly treat severe allergic reactions.

You can review additional information about epinephrine and the use of EpiPens in the “Alpha- and Beta-Receptor Agonists (Catecholamines)” section of the “Autonomic Nervous System” chapter.

Section 5.15 Light Bulb Moment Case Study 3 (Rheumatoid Arthritis Scenario)

1. The common side effects of prednisone use include insomnia, increased appetite, weight gain, fluid retention, increased thirst, and mood changes.

2. The nurse can suggest nonpharmacologic approaches such as practicing good sleep hygiene, relaxation techniques, and establishing a consistent sleep routine. Additionally, the nurse can also talk to the health care provider about adjusting the timing or dosage of prednisone to help reduce the patient’s insomnia.

3. The nurse can advise the patient to increase her fluid intake with noncaffeinated drinks, such as water and herbal tea. The nurse should also encourage the patient to avoid salty and processed foods. The nurse can also educate the patient on the importance of regular monitoring of her blood sugar levels, as increased thirst can be a sign of hyperglycemia.

4. The nurse should educate the patient on the possible side effects of prednisone use, including the potential for increased appetite, fluid retention, and mood changes. The nurse should also emphasize the importance of taking the medication as prescribed, not discontinuing it suddenly, and discussing any concerns or questions about prednisone use with the health care provider. The patient should also be advised to follow a healthy diet, engage in regular physical activity, and get enough rest to minimize the potential side effects of prednisone.