A patient who was recently diagnosed with COPD comes to the ...

[saraeharris]

A patient who was recently diagnosed with COPD comes to the clinic for a follow-up evaluation after beginning therapy with a SABA as needed for dyspnea. The patient reports occasional mild exertional dyspnea but is able to sleep well.
 
  The patient's FEV1 in the clinic is 85 of predicted, and oxygen saturation is 96. The primary care NP should recommend: a. a combination LABA/ICS twice daily.
  b. influenza and pneumococcal vaccines.
  c. ipratropium bromide (Atrovent) twice daily.
  d. home oxygen therapy as needed for dyspnea.

Question 2

A parent calls a clinic for advice about giving an over-the-counter cough medicine to a 6-year-old child. The parent tells the NP that the medication label does not give instructions about how much to give a child. The NP should:
 
  a. order a prescription antitussive medication for the child.
  b. ask the parent to identify all of the ingredients listed on the medication label.
  c. calculate the dose for the active ingredient in the over-the-counter preparation.
  d. tell the parent to approximate the dose at about one third to one half the adult dose.

[maya.nigrin17@yahoo.com]

Answer to Question 1

B
Influenza and pneumococcal immunizations are recommended to help reduce comorbidity that will affect respiratory status. This patient is stable with the prescribed medications, so no additional medications are needed at this time. Home oxygen therapy is used for patients with severe resting hypoxemia.

Answer to Question 2

B
Over-the-counter cough medications often contain dextromethorphan, which can be toxic to young children. It is important to identify ingredients of an over-the-counter medication before deciding if it is safe for children. A prescription antitussive is probably not warranted until the cough is evaluated to determine the cause. Until the ingredients are known, it is not safe to approximate the child's dose based on only the active ingredient.

[saraeharris]

Thank you!

[maya.nigrin17@yahoo.com]

Always glad to help...