The nurse realizes that the medication tiotropium bromide ...

[Mimi]

The nurse realizes that the medication tiotropium bromide (Spiriva) is contraindicated for a patient with chronic obstructive pulmonary disease (COPD). What information in the patient's medical history led to this clinical decision?
 
  Select all that apply.
 
  1. The patient is being treated for glaucoma.
  2. The patient uses a topical steroid for psoriasis.
  3. The patient attends physical therapy three times a week.
  4. The patient is taking medication for prostatic hypertrophy.
  5. The patient limits the intake of dietary fats for weight loss.

Question 2

The nurse instructs a patient on the use of a metered-dose inhaler for asthma medications. To demonstrate understanding of the instructions, in which order should the patient self-administer this medication?
 
  1. Rinse the mouth.
  2. Exhale slowly and completely.
  3. Shake the canister vigorously for 3 to 5 seconds.
  4. Press and hold the canister down while inhaling deeply and slowly for 3 to 5 seconds.
  5. Hold the breath for 10 seconds, release the pressure on the container, remove from the mouth, and exhale.

[poopface]

Answer to Question 1

Correct Answer: 1, 4
Contraindications to tiotropium bromide (Spiriva) include glaucoma and prostatic hypertrophy. This medication is not contraindicated in with a topical steroid, physical therapy, or a low-fat diet.

Answer to Question 2

Correct Answer: 3, 2, 4, 5, 1
: The canister is shaken before the medication is administered. The patient exhales before administering the medication. The canister is pressed and held down while the patient inhales. This step takes 3 to 5 seconds. The breath is held for 10 seconds after the medication is administered. Then the pressure on the canister is released and the canister is removed from the mouth. The patient can then exhale. The mouth is rinsed after the medication is inhaled.

[Mimi]

Excellent

[scottmt]

Gracias!