Author Question: A 50-year-old patient who recently quit smoking reports a frequent morning cough productive of ... (Read 46 times)

Lobcity · **on:** Jul 24, 2018

A 50-year-old patient who recently quit smoking reports a frequent morning cough productive of yellow sputum. A chest x-ray is clear, and the patient's FEV1 is 80 of predicted. Pulse oximetry reveals an oxygen saturation of 97.

The primary care NP auscultates clear breath sounds. The NP should: a. reassure the patient that these symptoms will subside.
b. prescribe a moderate-dose ICS twice daily.
c. order a long-acting anticholinergic with albuterol twice daily.
d. prescribe an albuterol metered-dose-inhaler, 2 puffs every 4 hours as needed.

Question 2

A woman who is breastfeeding her infant asks the primary care NP what she can use for headaches while she is nursing. The NP tells her:

a. most medications enter breast milk and are not safe.
b. most over-the-counter medications are safe for the breastfed infant.
c. she may need to interrupt breastfeeding when taking headache medications.
d. she should consider weaning her infant to formula if her headaches are frequent.

chem1s3 · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

D
For patients with stable COPD having respiratory symptoms with FEV1 between 60 and 80 of predicted, inhaled bronchodilators may be used. COPD is not reversible, and the symptoms will not subside. ICS therapy or long-acting anticholinergics are recommended when FEV1 is less than 60.

Answer to Question 2

B
Most over-the-counter medications are considered safe for the breastfed infant and do not necessitate a disruption of breastfeeding, even though most medications cross easily into breast milk. Any interruption of breastfeeding carries a risk of premature weaning and so is indicated only when the mother must take medications known to cause serious harm to the baby. It is not recommended that she wean her infant to formula when she needs medications for her headaches.