An NP orders an inhaled corticosteroid 2 puffs twice daily and an albuterol metered-dose inhaler 2 puffs every 4 hours as needed for cough or wheezing for a 65-year-old patient with recent onset of reactive airways disease who reports symptoms
occurring every 1 or 2 weeks. At a follow-up appointment several months later, the patient reports no change in frequency of symptoms. The NP's initial action should be to: a. order spirometry to evaluate pulmonary function.
b. prescribe a systemic corticosteroid to help with symptoms.
c. ask the patient to describe how the medications are taken each day.
d. give the patient detailed information about the use of metered-dose inhalers.
C
It is essential to explore with the older patient what he or she is actually doing with regard to daily medication use and compare this against the "prescribed" medication regimen before ordering further tests, prescribing any increase in medications, or providing further education.
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