A patient with asthma uses albuterol (Ventolin) for wheezing. The ...

[brutforce]

A patient with asthma uses albuterol (Ventolin) for wheezing. The nurse assesses the patient and notes vital signs of HR, 96 beats per minute; RR, 18 breaths per minute; and BP, 116/78 mm Hg.
 
  The patient has clear breath sounds and hand tremors. What will the nurse do?
  a. Ask the patient how often the inhaler is used.
  b. Check the patient's blood glucose level.
  c. Request an order for isoproterenol (Isuprel) to reduce side effects.
  d. Stop the medication and report the tremors to the provider.

Question 2

Small doses of tubocurarine are administered when patients are suspected of having a myasthenia gravis crisis.
 
  If the patient develops increased muscle weakness in response to the tubocurarine, the nurse should prepare to administer what kind of drug?
  a. Cholinesterase inhibitor
  b. Dopamine agonist
  c. Ganglionic blocker
  d. Neuromuscular blocking agent

[jaygar71]

Answer to Question 1

ANS: A
Tachycardia is a response to activation of beta1 receptors. It can occur when large doses of albuterol are used and selectivity decreases. The nurse should question the patient about the number of inhalations used. Isoproterenol can cause hyperglycemia in diabetic patients. Isoproterenol has more side effects than albuterol. Tremors are an expected side effect and are not an indication for stopping the drug.

Answer to Question 2

ANS: A
If the patient displays increased muscle weakness, this is an adverse effect of the tubocurarine, and respiratory depression may ensue. A dopamine antagonist would not be indicated to reverse the effects of the tubocurarine. Ganglionic blockers interrupt impulse transmission through ganglia of the autonomic nervous system; they are nonselective and no longer have therapeutic uses. A neuromuscular blocking agent would increase muscle paralysis and make the condition worse.

[brutforce]

Thank you!

[jaygar71]

Always glad to help...