A patient with asthma comes to a clinic for treatment of an asthma exacerbation. The patient uses an inhaled glucocorticoid, montelukast (Singulair), and a SABA via MDI
The nurse assesses the patient and notes a respiratory rate of 18 breaths per minute, a heart rate of 96 beats per minute, and an oxygen saturation of 95%. The nurse auscultates mild expiratory wheezes and equal breath sounds bilaterally. What will the nurse do?
a. Contact the provider to request a systemic glucocorticoid.
b. Contact the provider to suggest using a long-acting beta2 agonist.
c. Evaluate the need for teaching about MDI use.
d. Question the patient about how much albuterol has been used.
ANS: D
To determine the next course of action, it is important to assess the drugs given before these symptoms were observed. Patients who continue to wheeze after using a SABA need systemic glucocorticoids and nebulized albuterol. If a SABA has not been used, that will be the first intervention. LABAs are not used for exacerbations. If a patient reports using a SABA without good results, evaluating the MDI technique may be warranted.
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