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Pharmacology for Nurses

Chapter 25

Pharmacology for NursesChapter 25

Unfolding Case Study

1.
b. Based on Harold’s smoking history, decreased breath sounds, prolonged expiration, and mild wheezing, the nurse should anticipate a diagnosis of COPD.
2.
a. Beta-adrenergic agonists, such as salmeterol, are often used as part of long-term management for COPD. They provide bronchodilation and help improve airflow by relaxing the airway smooth muscles.
3.
a. Corticosteroids like beclomethasone work to reduce and prevent inflammation in the airways.
4.
d. Corticosteroids can cause the adverse reaction of candidiasis. Rinsing the mouth helps to prevent candidiasis.

Review Questions

1.
c. Albuterol is a short-acting beta-agonist that works by stimulating beta-2 adrenergic receptors in the airway smooth muscles.
2.
a. 60 ÷ 3 = 20.
3.
c. Theophylline is a xanthine derivative medication used for long-term control of asthma symptoms.
4.
c. Ipratropium bromide is a respiratory anticholinergic medication that acts by blocking the action of acetylcholine, a neurotransmitter that causes bronchoconstriction. By blocking acetylcholine, ipratropium bromide helps to relax the smooth muscles in the airways, leading to bronchodilation and improved airflow.
5.
d. First the nurse needs to determine the client’s weight in kilograms: 121 l b ÷ 2.2 k g = 55 k g . 55 k g × 4.6 m g / k g = 253 m g .
6.
c. The most commonly reported side effects of montelukast include headache and dizziness.
7.
d. Respiratory anticholinergic medications have the potential to worsen urinary retention due to their ability to relax smooth muscles, including those in the urinary tract.
8.
c. Abruptly stopping methylprednisolone, a corticosteroid medication, can lead to adrenal insufficiency. Long-term use of corticosteroids suppresses the adrenal glands, causing them to produce less cortisol. When the medication is abruptly discontinued, the adrenal glands may not be able to produce enough cortisol on their own, leading to adrenal insufficiency.
9.
a. Salmeterol is a long-acting beta-agonist that is not intended for quick relief during an asthma attack.
10.
c. Tiotropium is an anticholinergic medication that works by blocking the action of acetylcholine, a neurotransmitter that causes bronchoconstriction. By blocking acetylcholine, tiotropium helps to relax the smooth muscles in the airways, leading to bronchodilation and improved airflow.
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