A patient with a history of chronic obstructive pulmonary disease (COPD) is prescribed tiotropium (Spiriva) inhaler. Which instruction should the nurse include in patient education about tiotropium inhaler use?

Correct Answer: B

Rationale: Tiotropium (Spiriva) is an anticholinergic bronchodilator used for the management of COPD. A common side effect of anticholinergic medications is dry mouth. Rinsing the mouth with water after using the inhaler can help reduce the risk of developing oral thrush or other mouth infections due to dryness. This instruction helps promote good oral hygiene and decreases the potential side effects associated with tiotropium inhaler use. This teaching is important for patients to follow to ensure their overall health and well-being while using the medication.

Correct Answer: C

Rationale: Beta-adrenergic agonists stimulate beta-adrenergic receptors in the heart, leading to an increase in heart rate (tachycardia). This is a common adverse effect associated with the use of beta-adrenergic agonists in the management of conditions such as asthma. Monitoring for tachycardia is important because it can potentially lead to other complications such as palpitations, arrhythmias, and exacerbation of underlying cardiovascular conditions. It is essential for the nurse to closely monitor the patient for any signs or symptoms of tachycardia and report any abnormalities to the healthcare provider promptly to ensure appropriate management and prevent further complications.

Correct Answer: B

Rationale: Antipsychotic medications can cause metabolic side effects, including hyperglycemia (high blood sugar). Patients with bipolar disorder who are prescribed antipsychotic medications are at risk for developing new-onset diabetes or exacerbating preexisting diabetes. Monitoring blood glucose levels is essential to detect hyperglycemia early and prevent complications such as diabetic ketoacidosis. While hypertension, hypotension, and hypernatremia are possible side effects of certain medications, they are not typically associated with antipsychotic medications commonly used in the management of bipolar disorder. Hyperglycemia is a serious concern in this population due to the risk of developing diabetes or worsening of existing diabetes.

Correct Answer: B

Rationale: The nurse's priority action when noticing an abnormal heart rhythm on the patient's cardiac monitor during surgery is to assess the patient's vital signs and symptoms. This is important because the nurse needs to gather more information about the patient's condition to determine the significance of the abnormal rhythm and the potential impact on the patient's health. By assessing the vital signs and symptoms, the nurse can obtain a more complete picture of the situation and make informed decisions about the next steps in caring for the patient. Once the assessment is done, appropriate actions such as administering medication or notifying the anesthesiologist can be taken based on the findings.

Correct Answer: C

Rationale: If the nurse observes an unusual odor emanating from the surgical site during surgery, it is important to inform the surgeon immediately and assess for signs of infection. Changes in odor can sometimes be an early sign of infection, which requires prompt attention and intervention. By communicating with the surgeon and conducting a thorough assessment, the nurse can help ensure the timely detection and management of any potential complications, such as infection, that may be affecting the patient's surgical outcome. Prompt action in response to unusual observations is crucial to maintaining patient safety and well-being during surgical procedures.