The nurse is teaching a patient with asthma about using a metered-dose inhaler to administer ...

The answer to question 1

A, B
Inhaled medications are designed to produce local effects; for example, bronchodilators open narrowed bronchioles. However, because these medications are absorbed rapidly through the pulmonary circulation, some have the potential for producing systemic side effects. Holding the breath for 10 seconds after inhalation allows the aerosol to penetrate deeper areas of the lung.
Exhalation should occur slowly through the nose or pursed lips to keep the small airways open during exhalation. About 2 minutes after the last dose, the mouth should be rinsed with warm water because inhaled bronchodilators may cause dry mouth and taste alterations.

The answer to question 2

A, B, C
A nasogastric feeding tube, a percutaneous endoscopic gastrostomy (PEG) tube, and a jejunostomy tube are used to administer enteral feedings and can also be used to administer medications. Do not administer medications into nasogastric tubes that are inserted for decompression.

The answer to question 3

A, B, C
Cyanosis caused by hypoxia is observed in the oral mucosa, in the conjunctiva of the eye, and around the lips, known as circumoral cyanosis. Nail bed cyanosis may be caused by peripheral vascular disease or cold temperatures.

The answer to question 4

B, C, D
Topical medications can be applied by direct application of liquid (eyedrops, gargling, swabbing the throat), insertion of a drug into a body cavity (rectal or vaginal suppositories, vaginal creams or foams), instillation of fluid into a body cavity (fluid is retained) (eardrops, nose drops, bladder and rectal instillation), irrigation of a body cavity (fluid is not retained) (flushing eye, ear, vagina, bladder, or rectum with medicated fluid), spraying (instillation into nose or throat or under the tongue), and inhalation of medicated aerosol spray or dry powder medication (distributes medication throughout the nasal passages and the tracheobronchial airway). Medication may be directly applied to the skin or mucosa (lotion, ointment, cream, powder, foam, spray, patch, and disc), or it may be given by the sublingual (medication placed under the tongue and allowed to dissolve) or buccal (medication placed between the upper or lower molar teeth and cheek area and allowed to dissolve) route. Medications placed in the gastrointestinal tract via an enteral tube are not topical medications.

The answer to question 5

B, C
Hypoxemia is a deficiency of arterial blood oxygen. Decreased hemoglobin levels reduce the amount of oxygen transported to the cells. Acidemia (decreased blood pH) increases the ability of hemoglobin to release oxygen to the tissues. Alkalemia (increased blood pH) decreases the ability of hemoglobin to release oxygen to the tissues.

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