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M.A., a 55-year-old woman, was recently diagnosed with bronchial asthma. In the past week, M.A. has...

M.A., a 55-year-old woman, was recently diagnosed with bronchial asthma. In the past week, M.A. has had three asthmatic attacks and had to use her abuterol inhaler. M.A takes an inhaled combination glucocorticoid (fluticasone propionate 100mcg/salmeterol 50 mcg) on a daily basis.

Explain the purpose for inhaled glucocorticoid therapy? What are the advantages to this drug classification?

What patient teaching is included with glucocorticoid therapy? Can they be used to treat an asthmatic attack? Explain.

Why was M.A. prescribed albuterol? How does it work?

What are the assessment and nursing interventions for bronchodilators?

What is included in patient teaching for bronchodilators?

The provider provides montelukast to M.A’s daily regimen. Why was this medication prescribed?

What are the nursing interventions and patient teaching for leukotriene receptor antagonists (montelukast)? Explain your answer.

Solutions

Expert Solution

Explain the purpose for inhaled glucocorticoid therapy? What are the advantages to this drug classification?

Inhaled glucocorticoids reduce airway edema/ inflammation.

Longtem corticosteroids usually lead to many side effects including weightgain, poor glucose control and immono supression. Inhaled corticosteroids have less systemic effects. Since inhaled drugs are delivered directly to the respiratory system, faster action can be expected.

What patient teaching is included with glucocorticoid therapy? Can they be used to treat an asthmatic attack? Explain.

Patient teaching

Glucocorticorticoids if taken orally should be taken along with food and systemic dose is better to be taken in the morning to match cortisol secretion cycle

  • Educate about side effects
  • needs monitoring for longterm use
  • never stop the drug without follow up, needs tapering before stopping the drug

Yes,Corticosteroids can be used to treat airway edema in acute asthmatic attacks. It is usually given a s IV dose in acute asthma along with bronchodilators and later shifted to oral/ inhalants after the patient condition improves

Why was M.A. prescribed albuterol? How does it work?

Albuterol is a bronchodilator.It relaxes brochial smooth muscles, reverse the effect of bronchoconstriction, and thereby airway narrowing is minimized. Thus it improves air entry as well as symptoms

What are the assessment and nursing interventions for bronchodilators?

Assessment

  • check for drug allergies
  • peak flow rates PEFR
  • respiratory assessment- baseline

Implications

  • use with caution in cardic patients
  • have a gp of 5-10 minutes between two drug inhalations if two drugs are prescribed
  • monitor effectiveness
  • check for side effects: tachycardia, increased BP,tremors ets
  • educate the patient regarding adverse effects
  • teach patient about use of devices for delivery of drugs
  • teach how to check for drugs in inhaler
  • report side effects

What is included in patient teaching for bronchodilators?

Major aspects include

  • Take bronchodilators on time
  • Be regular
  • Do not skip doses
  • need regular follow up
  • ensure that there is no interaction with other medications
  • monitor cardiac status and electrolytes
  • report side effects

The provider provides montelukast to M.A’s daily regimen. Why was this medication prescribed?

Monteleukast is a leukotreine inhibitor and reduces airway inflammation and reactivity of airways and controls recurrent attacks

What are the nursing interventions and patient teaching for leukotriene receptor antagonists (montelukast)?

  • periodic testing of liver fuinction needed
  • use chewable tablets with caution
  • do not breastfeed when on monteleukast
  • dose better to be taken in evening
  • protect from light
  • monitor effectivenes if the patient taked drugs like phenobarbital

Reference

  • http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/M085.html
  • https://mynotesonnursing.wordpress.com/tag/bronchodilators/

Nightingale answered 2 years ago
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