A client with moderate and persistent asthma has obtained control with a formoterol inhaler qid for bronchospasm for several years
In the past couple of weeks, however, the client has been reporting more chest tightness and wheezing during the day. The nurse recognizes that the most likely problem is that the client:
1. is not taking the medication as directed.
2. needs to have the dose reduced and work back up to the full dose.
3. has developed a tolerance to the medication.
4. needs an inhaled steroid.
Correct Answer: 3
Rationale 1: Clients sometimes develop tolerance to the beta-adrenergic binding effects of inhaled bronchodilators even when taking medication as directed.
Rationale 2: Clients sometimes develop tolerance to the beta-adrenergic binding effects of inhaled bronchodilators. Decreasing the dose may cause an exacerbation of symptoms.
Rationale 3: Clients sometimes develop tolerance to the beta-adrenergic binding effects of inhaled bronchodilators.
Rationale 4: The client may need an inhaled steroid but this would not account for why the current medication is not working.
Global Rationale: Drug tolerance is possible with the beta agonists and sympathomimetics. Decreasing the dose may cause an exacerbation of symptoms. The client may need an inhaled steroid but this would not account for why the current medication is not working.
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