The male client states he takes levalbuterol (Xopenex) by metered-dose inhaler (MDI) five to six times a day, and this dosage exceeds the provider's prescription
Which does the nurse imple-ment to maintain an effective airway? (Select all that apply.) 1. Inform provider that client is overdosing on medication.
2. Remove inhalers from the client and clarify prescription.
3. Discuss potential adverse effects of excessive inhaler use.
4. Determine client's knowledge and understanding of agent.
5. Increase the provider's prescription to reflect client's usage.
6. Ask client to explain technique used to dispense medication.
3, 4, 6
3. Typical prescriptions for levalbuterol dispense the medication by MDI three to four times a day; thus, the client is self-administering excessive medication. Potential reasons for excessive dosing include exacerbation of the illness, incorrect technique, ineffective therapy, client misunderstanding, and an empty inhaler container.
4. To assess the situation, the nurse gathers additional information from the client. The information can provide clues about the client's excessive dosing that the nurse can use to solve the problem.
6. The client's MDI technique is valuable data; if the client is using the MDI incor-rectly, additional client teaching and coaching potentially facilitate medication deliver to deeper parts of the lung to increase its effectiveness by dilating bronchioles. The client can potentially benefit from using a spacer and by counting doses from each canister.
1. Consulting with the provider is premature because the nurse needs additional in-formation to share in the consultation.
2. If the inhalers belong to the client, the nurse cannot remove them; removing the inhalers is likely to cause client dissatisfaction.
5. The nurse does not alter the prescription without prescribing authority.
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