Ati Nursing Comprehensive

ATI NURSING COMPREHENSIVE NP1 PAGE 1 NP2 PAGE 36 NP3 PAGE 68 NP4 PAGE 96 NP5 PAGE 131 Situation 1 - Mr. Ibarra is assigned to the triage area and while on duty, he assesses the condition of Mrs. Simon who came in with asthma. She has difficulty breathing and her respiratory rate is 40 per minute. Mr. Ibarra is asked to inject the client epinephrine 0.3mg subcutaneously 1. The indication for epinephrine injection for Mrs. Simon is to: a. Reduce anaphylaxis b. Relieve hypersensitivity to allergen c. Relieve respiratory distress due to bronchial spasm d. Restore client's cardiac rhythm CORRECT ANSWER: C RATIONALE: Asthma is a chronic inflammatory disorder of the airways resulting in reversible bronchoconstriction and air hunger in response to triggers from a variety of sources. When exposed to a trigger, the hyperactivity of the medium-sized bronchi causes the release of leukotrienes, histamine and other substances from the mast cells of the lung; these agents intensify the inflammatory process and cause bronchospasm. When inhaled in small doses, epinephrine causes short-term relief from the symptoms by widening the bronchial tubes allowing air to pass through. Once again epinephrine is not the best cure, but a temporary relief when an asthma inhaler is not present. OPTIONS A & D are incorrect OPTION B: Epinephrine does have a direct effect to relieve hypersensitivity to allergen SOURCE: Hogan, Mary Ann and Hill, Karen.Prentice Hall.Reviews and Rationales series for nursing. P.4-5; 2. When preparing the epinephrine injection from an ampule, the nurse initially: a. Taps the ampule at the top to allow fluid to flow to the base of the ampule b. Checks expiration date of the medication ampule c. Removes n