The nurse takes an admission history on a patient with possible ...

[LCritchfi]

The nurse takes an admission history on a patient with possible asthma who has new-onset wheezing and shortness of breath. Which information may indicate a need for a change in therapy?
 
  a. The patient has chronic inflammatory bowel disease.
  b. The patient has a history of pneumonia 6 months ago.
  c. The patient takes propranolol (Inderal) for hypertension.
  d. The patient uses acetaminophen (Tylenol) for headaches.

Question 2

The nurse completes an admission assessment on a patient with asthma. Which information given by patient is most indicative of a need for a change in therapy?
 
  a. The patient uses albuterol (Proventil) before any aerobic exercise.
  b. The patient says that the asthma symptoms are worse every spring.
  c. The patient's heart rate increases after using the albuterol (Proventil) inhaler.
  d. The patient's only medications are albuterol (Proventil) and salmeterol (Serevent).

[ebenov]

Answer to Question 1

ANS: C
-Blockers such as propranolol can cause bronchospasm in some patients with asthma. The other information will be documented in the health history but does not indicate a need for a change in therapy.

Answer to Question 2

ANS: D
Long-acting 2-agonists should be used only in patients who also are using an inhaled corticosteroid for long-term control. Salmeterol should not be used as the first-line therapy for long-term control. Using a bronchodilator before exercise is appropriate. The other information given by the patient requires further assessment by the nurse, but is not unusual for a patient with asthma.