James P. is a 20-year-old nursing student. He is being treated for seasonal allergies and asthma at the college health center, which have worsened during the fall semester. The physician’s assistant on duty has prescribed an albuterol inhaler for his asthma and pseudoephedrine (Sudafed) for symptoms of his seasonal allergies. He presents as a client in the dental hygiene clinic, and upon reviewing his medical history and taking his vital signs, the dental hygiene student notes that his blood pressure is 140/90 and his pulse rate is 120. James reports that his blood pressure is usually in the 120/80 range and his pulse is usually 90. He also reports feeling nervous and “jittery” and has lost his appetite. He also tells the clinician that he took ibuprofen for his headache this morning. During the intraoral examination, the clinician notes a lack of saliva, and James states that his mouth has been feeling dry lately. What is albuterol ? , Antihistamine, Antibiotic, Decongestant, Bronchodilator, Which rationales could account for the elevated blood pressure and pulse rate at James’s dental hygiene appointment?, Anxiety about dental treatment, a and b only, a, b, and c, Pseudoephedrine, Ibuprofen, All of James’s symptoms could be caused by the pseudoephedrine except:, Loss of appetite, Dry mouth, Anxiety and nervousness, Increased heart rate and blood pressure, Headache, Which interventions should the dental hygienist make to encourage James’s oral and systemic health?, Have James’s inhaler present during the appointment., Employ stress-reduction protocol to avoid triggering an asthma attack., All of the above are appropriate interventions for the dental hygienist., Recommend xylitol sugar-free gum and alcohol-free mouth rinse for relief of dry mouth symptoms., Monitor vital signs closely., Which is the mechanism of action of James’s albuterol inhaler in treatment of his asthma?, Bronchodilation, a and b only, Vasodilation, Suppression of inflammation, a and d only, Decongestion, A short time into the dental hygiene treatment appointment, James has an asthma attack, and although he uses his inhaler, the attack worsens and cannot be brought under control. Which drug should be administered to James to halt the asthma attack?, Oxygen, An additional dose of his atenolol, Epinephrine, An additional dose of pseudoephedrine, all of the above, a and b only, Parenteral administration of epinephrine would have which other systemic effects?, a. Miosis, b. Mydriasis, c. Hypoglycemia, D) Hyperglycemia, e. Decrease in blood pressure and heart rate, F) Increase in blood pressure and heart rate, a, c, and e, b, d, and f.

James Case study- Chapter 4

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