In a patient, the physician prescribes to inhale beclomethasone and Albuterol (Ventolin HFA) for the treatment of asthma. As a Nursing Officer, how will you administer these medications?

1. A

   First administer beclomethasone then administer the albuterol

2. B

   First administer albuterol then administer beclomethasone.

3. C

   Preference on the patient

4. D

   Alternatively give the dose

Appeared in: NORCET 3 - 2022 (Shift-1)

Explanation

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• Albuterol is a short-acting beta-agonist (SABA), a type of bronchodilator that works quickly to open constricted airways.
• Beclomethasone is an inhaled corticosteroid (ICS) that reduces inflammation in the airways.
• Administering the bronchodilator (albuterol) first allows the airways to widen, which enables the corticosteroid (beclomethasone) to penetrate deeper into the lungs.
• This sequence maximizes the anti-inflammatory effect of the corticosteroid, leading to better asthma control and symptom relief.

Why Other Options Were Wrong

• Option A: Administering the corticosteroid (beclomethasone) before the bronchodilator is incorrect. The airways are still narrowed, which will limit the amount of steroid medication that reaches the smaller airways, reducing its effectiveness.
• Option C: The order of medication administration is determined by pharmacological principles for optimal efficacy, not by the patient's preference. Patient education is key to ensuring adherence to the correct procedure.
• Option D: This option is vague and incorrect. A specific, evidence-based sequence is required to achieve the desired therapeutic outcome. Administering them 'alternatively' without a clear order would lead to inconsistent and suboptimal drug delivery.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Pharmacology and administration of inhaled respiratory medications (SABA and ICS) to guide bedside assessment, documentation, and the next nursing action.
• Patient education is a critical nursing responsibility. The nurse must teach the patient the correct sequence, the reason for it, and the proper technique for using each inhaler.
• A key safety instruction is to rinse the mouth with water and spit after using an inhaled corticosteroid like beclomethasone. This simple action significantly reduces the risk of developing oral candidiasis (thrush).
• Proper administration technique directly impacts treatment efficacy. Failure to follow the correct sequence can lead to poor asthma control and increased exacerbations.

How to Approach the Question

• First, identify the drug classes of the medications mentioned. Albuterol is a bronchodilator (a short-acting beta-agonist or SABA), and beclomethasone is an anti-inflammatory agent (an inhaled corticosteroid or ICS).
• Recall the primary function of each drug class. Bronchodilators open the airways, while corticosteroids reduce inflammation within those airways.
• Apply the logical principle of drug delivery: to effectively treat inflammation deep in the lungs, the pathways must first be open.
• Conclude that the bronchodilator must be administered before the corticosteroid.
• Evaluate the options based on this principle. The only option that follows the 'dilate first, then treat inflammation' sequence is the correct answer.

Concept Tested & Keywords

• Concept Tested: Pharmacology and administration of inhaled respiratory medications (SABA and ICS).
• Stem keywords: beclomethasone, Albuterol, Ventolin HFA, asthma, administer medications
• Lead-in keywords: how will you administer

Question ID

QH5Nn5USWxReL21h-0bUke

Copy ID

Reference Book

E6 Pharmacology Nursing Lilley 11e Part 2 p. 286-288