A client has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?

Correct Answer: B

Rationale: When a client is prescribed an inhaled beta2-agonist (such as albuterol) and an inhaled glucocorticoid (such as beclomethasone) for asthma control, the beta2-agonist should be administered first. This sequence is important because the beta2-agonist promotes bronchodilation, which enhances the absorption and effectiveness of the glucocorticoid. Therefore, instructing the client to administer the albuterol inhaler before using the beclomethasone inhaler ensures optimal therapeutic benefit.

Correct Answer: A

Rationale: Propranolol is a nonselective beta-adrenergic blocker that blocks both beta1 and beta2 receptors. Blockade of beta2 receptors in the lungs causes bronchoconstriction, making it contraindicated in clients with asthma. Using propranolol in asthma can exacerbate bronchoconstriction and potentially lead to respiratory distress or exacerbation of asthma symptoms.

Correct Answer: B

Rationale: Verapamil, a calcium-channel blocker, can increase digoxin levels, leading to toxicity. When given together, the digoxin dosage may need adjustment, and the nurse should closely monitor the client's digoxin levels to prevent toxicity symptoms such as nausea, vomiting, visual disturbances, and arrhythmias.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Metoprolol. When a client prescribed Isosorbide Mononitrate for chronic stable angina develops reflex tachycardia, the nurse would administer Metoprolol. Metoprolol is a beta-blocker that works by blocking the effects of adrenaline on the heart, thereby reducing heart rate and blood pressure. By administering Metoprolol, the nurse can counteract the reflex tachycardia caused by Isosorbide Mononitrate, leading to a more balanced cardiovascular response. Now, let's analyze why the other options are incorrect: A) Furosemide: Furosemide is a loop diuretic used to treat conditions like heart failure and edema by promoting diuresis. It does not address reflex tachycardia. B) Captopril: Captopril is an ACE inhibitor often used in hypertension and heart failure. While it may be beneficial in some cardiovascular conditions, it does not directly address reflex tachycardia. C) Ranolazine: Ranolazine is used in chronic angina to reduce the frequency of episodes. It does not specifically target reflex tachycardia. Educational context: Understanding the pharmacological management of cardiovascular conditions is crucial for nurses to provide safe and effective care. Knowing the actions of different drug classes and their specific indications helps in making informed decisions like choosing the appropriate medication to address specific side effects or complications, as seen in this case of reflex tachycardia with Isosorbide Mononitrate.

Correct Answer: C

Rationale: The correct action the nurse should plan to take when administering Propranolol is to assist the client when sitting up or standing after taking the medication. Propranolol can lead to orthostatic hypotension, causing dizziness upon sudden position changes. It is essential to help the client with position changes to prevent falls or injury.