When treating a patient who's been taking tricyclic antidepressants for the past three months and has just been prescribed albuterol, a nurse should understand that

Correct Answer: C

Rationale: In this scenario, option C is the correct answer because tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) can increase the risk of tachycardia and angina when taken with beta 2 adrenergic agonists like albuterol. This interaction can lead to cardiovascular complications due to the combined effects on heart rate and blood pressure. Option A is incorrect because TCAs are more likely to cause tachycardia rather than bradycardia when combined with beta 2 adrenergic agonists. Option B is incorrect as TCAs do not increase the risk of gastric ulcers, and they do not need to be taken with a fatty meal. Option D is incorrect as TCAs are not associated with pulmonary edema leading to peripheral edema and anasarca. Educationally, understanding drug interactions is crucial for healthcare professionals to ensure safe and effective patient care. This question highlights the importance of recognizing potential adverse effects when combining different classes of medications, emphasizing the need for thorough medication reconciliation and monitoring for drug interactions in clinical practice.

Correct Answer: B

Rationale: In the context of hematology and pharmacology, understanding drug interactions is crucial for safe and effective patient care. In this scenario, the correct answer is option B) Phenobarbital, phenytoin, and rifampin. Methylxanthines, like theophylline, are metabolized in the liver by the cytochrome P450 system. Phenobarbital, phenytoin, and rifampin are known to induce cytochrome P450 enzymes, leading to increased metabolism of methylxanthines. This accelerated metabolism can result in subtherapeutic levels of methylxanthines, reducing their effectiveness in treating chronic asthma. Option A) Cimetidine, ciprofloxacin, and other fluoroquinolone antibiotics are inhibitors of cytochrome P450 enzymes, which would lead to increased levels of methylxanthines, potentially causing toxicity rather than the desired therapeutic effect. Option C) Albuterol and TCAs do not significantly impact the metabolism of methylxanthines and do not require a dosage adjustment when used concurrently. Option D) None of the listed drugs pose a risk when taken with methylxanthines is incorrect because, as explained above, certain drugs can interact with methylxanthines, affecting their metabolism and efficacy. Educationally, this question highlights the importance of understanding drug interactions, especially in patients with chronic conditions like asthma who may be on multiple medications. Nurses need to be aware of potential interactions to ensure safe and effective pharmacological management for their patients.

Correct Answer: A

Rationale: The correct answer is A) Peanut allergy. Inhalable anticholinergics, such as ipratropium bromide, are commonly used to treat bronchospasms by dilating the airways in conditions like asthma and chronic obstructive pulmonary disease (COPD). Peanut allergy is a potential contraindication because ipratropium bromide inhalers may contain soya lecithin, which is derived from soybean oil. Patients with peanut allergies are at a higher risk of also being allergic to soy products due to cross-reactivity. Option B) Penicillin allergy is not a common contraindication for inhalable anticholinergics as they are unrelated drug classes with different mechanisms of action. Option C) Shellfish allergy is also not directly related to inhalable anticholinergics and would not typically be a contraindication for this medication. Option D) Iodine allergy is not a common contraindication for inhalable anticholinergics. Iodine is not a component commonly found in these medications, so an iodine allergy would not typically impact their use. In an educational context, understanding common contraindications for medications is crucial for safe and effective nursing practice. Nurses need to be aware of potential allergies and contraindications to medications to prevent adverse reactions and provide optimal patient care. Connecting specific allergies to medication components, like the association between peanut allergy and soy products in this case, highlights the importance of thorough patient assessments and medication knowledge in nursing practice.

Correct Answer: A

Rationale: The correct answer is A) bronchospasm is relieved. Beta 2 adrenergic agonists, like albuterol and salbutamol, selectively target and activate beta 2 receptors in the bronchial smooth muscle. This activation leads to the relaxation of the smooth muscle, resulting in bronchodilation. By dilating the bronchial passages, these medications help to relieve bronchospasms and improve airflow in conditions like asthma and chronic obstructive pulmonary disease (COPD). Option B) histamine release is potentiated is incorrect because beta 2 adrenergic agonists do not affect histamine release. Histamine release is more commonly associated with allergic reactions and inflammatory responses, and beta 2 agonists do not have a direct impact on this process. Option C) ciliary motility is decreased is also incorrect. Beta 2 adrenergic agonists primarily target bronchial smooth muscle and do not have a significant effect on ciliary motility. In fact, these medications are used to treat conditions where increased ciliary motility, such as in conditions like bronchitis, is beneficial for clearing mucus and improving airway function. In an educational context, understanding how beta 2 adrenergic agonists work is crucial for healthcare professionals, particularly those involved in managing patients with respiratory conditions. Knowing the mechanism of action helps in selecting the appropriate medications, understanding their therapeutic effects, and anticipating potential side effects. This knowledge also aids in patient education, as individuals with respiratory conditions can better comprehend how their medications work and why they are beneficial for their condition.

Correct Answer: A

Rationale: The correct answer is A) use the lowest dose possible to control manifestations. Glucocorticoids like Prednisone can lead to bone loss due to their negative effects on calcium absorption and bone formation. By using the lowest effective dose, the nurse can minimize this side effect while still managing the patient's symptoms effectively. Option B) giving PO Prednisone on a consistent daily dosing schedule is not directly related to preventing bone loss. Consistency in dosing is important for maintaining therapeutic levels but does not address the bone loss concern. Option C) counseling the patient to consume a diet with less calcium is incorrect as reducing calcium intake would further exacerbate the risk of bone loss. Adequate calcium intake is crucial for maintaining bone health, especially when taking medications that can affect bone density. Option D) refraining from weight-bearing exercises is also incorrect. Weight-bearing exercises are actually beneficial for improving bone density and strength, which can counteract the bone loss effects of glucocorticoids. Educationally, it is important for nurses to understand the side effects of medications like glucocorticoids and how to mitigate them. By optimizing dosing strategies and providing appropriate patient education on nutrition and exercise, nurses can help minimize the negative impacts of these drugs on bone health.