A skilled nursing facility patient with persistent dysphagia asks the attending nurse to crush a sustained release Theophylline tablet into his applesauce. What should be the most appropriate response?

Correct Answer: D

Rationale: The correct answer is D) Crushing this medication can cause severe toxicity like respiratory arrest. Theophylline is a drug commonly used to treat respiratory conditions like asthma and chronic obstructive pulmonary disease. When it is in a sustained-release form, crushing the tablet disrupts its intended slow release mechanism, leading to a rapid release of the entire drug dose at once. This can result in toxic levels of theophylline in the bloodstream, causing serious adverse effects such as seizures, arrhythmias, and respiratory arrest. Option A) Crushing this medication can cause profound hypoglycemia is incorrect because theophylline toxicity does not typically lead to hypoglycemia. Option B) Crushing this medication can cause acute kidney damage like ESRD is incorrect as theophylline toxicity primarily affects the cardiovascular and central nervous systems, not the kidneys. Option C) Crushing this medication can ruin your snack is clearly a distractor and not a valid consideration when dealing with medication administration and patient safety. In an educational context, it is crucial for healthcare professionals to understand the implications of altering sustained-release medications and the potential dangers of doing so. Proper patient education on medication administration is essential to prevent adverse events and ensure optimal therapeutic outcomes.

Correct Answer: A

Rationale: The correct answer is A) Blocks muscarinic receptors of the bronchi, resulting in bronchodilation. Used to treat allergen-induced and exercise-induced bronchospasm. Rationale: Ipratropium is an inhaled anticholinergic medication that works by blocking muscarinic receptors in the bronchi. This action leads to bronchodilation, making it an effective treatment for conditions like allergen-induced and exercise-induced bronchospasm. By inhibiting the effects of acetylcholine, which normally causes bronchoconstriction, ipratropium helps to open up the airways and improve breathing in patients with conditions like asthma and chronic obstructive pulmonary disease (COPD). Option B is incorrect because ipratropium does not potentiate b2 adrenergic receptors to cause bronchoconstriction; rather, it acts as an anticholinergic to promote bronchodilation. Option C is incorrect as ipratropium does not block a1 cholinergic receptors or cause bronchostimulation. Option D is also incorrect as ipratropium does not potentiate b1 cholinergic receptors or induce hyperpnea; its primary effect is bronchodilation through muscarinic receptor blockade. In an educational context, understanding the pharmacological action and therapeutic uses of hematology drugs like inhaled anticholinergics is crucial for healthcare providers managing patients with respiratory conditions. It is essential for healthcare professionals to have a solid grasp of how different medications work to select the most appropriate treatment options and optimize patient outcomes.

Correct Answer: C

Rationale: The correct answer is C) Medication dosage should be decreased. Rationale: - Prednisone, a glucocorticoid, can indeed cause myopathy as a known side effect. This is characterized by muscle weakness and can be a sign of steroid-induced myopathy. - Decreasing the medication dosage is the appropriate next step to alleviate the myopathy symptoms and prevent further muscle weakness. - Increasing the medication dosage (option A) can exacerbate the myopathy symptoms and lead to more severe side effects. - Changing the route of administration (option B) is not the primary intervention for managing myopathy caused by Prednisone. - Continuing Prednisone as prescribed (option D) without addressing the myopathy can worsen the patient's condition. Educational context: It's crucial for nurses and healthcare professionals to be aware of the potential side effects of medications, like glucocorticoids, to monitor patients effectively. Understanding the appropriate interventions for managing medication side effects, such as myopathy in this case, is essential for providing safe and effective patient care. Adjusting medication dosages based on observed side effects is a common practice to ensure patient well-being and prevent complications.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) guaifenesin can cause bronchospasm. When dealing with clients who have asthma, it is crucial to be cautious with medications that can potentially trigger or exacerbate bronchospasm, as this can lead to severe respiratory distress. Guaifenesin is known to have the potential to induce bronchospasm in some individuals, particularly those with underlying respiratory conditions like asthma. Option B) guaifenesin can cause bronchoconstriction, while similar to bronchospasm, is not the primary concern in asthma management. Bronchoconstriction refers to the narrowing of the airways due to smooth muscle contraction, which can contribute to breathing difficulties, but it is not as directly related to asthma exacerbations as bronchospasm. Option C) guaifenesin can cause decreased diameter of bronchial lumina is a distractor that is not physiologically accurate. Guaifenesin is not typically associated with directly decreasing the diameter of the bronchial lumina, which is why this option is incorrect. Educationally, understanding the potential effects of medications on specific patient populations, such as those with asthma, is crucial for healthcare providers to ensure safe and effective care. By being aware of the risks associated with certain medications like guaifenesin in asthma patients, healthcare professionals can make informed decisions to prevent adverse outcomes and provide optimal patient care.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) vasoconstrictive effects. When a nurse is educating patients with conditions such as hypertension, cerebrovascular disease, dysrhythmias, and coronary artery disease, it is important to avoid decongestants like Phenylephrine due to its vasoconstrictive effects. Vasoconstriction can lead to an increase in blood pressure, which can be harmful for patients with hypertension, cerebrovascular disease, and coronary artery disease as it can exacerbate their conditions. Patients with dysrhythmias may also be adversely affected by the vasoconstrictive effects of Phenylephrine. Option A) vasodilatory effects is incorrect as Phenylephrine actually has vasoconstrictive effects, not vasodilatory effects. Option C) sedative effects and Option D) mucolytic effects are also incorrect as Phenylephrine is not known for causing sedation or acting as a mucolytic agent. In an educational context, it is crucial for healthcare professionals to have a thorough understanding of the pharmacological effects of medications and how they can impact patients with specific health conditions. By educating patients about the potential risks associated with certain drugs like Phenylephrine, nurses can help prevent adverse reactions and promote patient safety.