Walkthrough: Pharmacological and Parenteral Therapies Q2 – NCLEX-RN®

00:01 A client who is diagnosed with an acute exacerbation of asthma is prescribed an intravenous corticosteroid medication.

00:08 Which statement by the nurse accurately describes this treatment.

00:13 Let's take a look at the topic.

00:15 So we know a client is the word that uses an NCLEX instead of patient.

00:19 So you'll see that when we're dealing with a client, who's a patient, they're diagnosed with an acute...

00:25 ah, that's a descriptor word.

00:27 So that means it's happening right now.

00:29 It's an acute exacerbation of asthma.

00:32 So they're having an asthma attack.

00:34 Now they've been prescribed, what type of corticosteroid medication? Yeah, that's one of those descriptor words.

00:41 Intravenous corticosteroid medication.

00:45 Now, we know that that's a common treatment with asthma, right? We know they go after something for the inflammation, which is the corticosteroid and something for the bronchoconstriction.

00:54 We're not dealing with bronchoconstriction here because they told us IV corticosteroid.

01:00 So which statement by the nurse accurately describes this treatment? So I'm looking for the best accurate description of intravenous corticosteroid medication.

01:12 Don't cut corners.

01:14 Pay close attention to those descriptor words.

01:17 Intravenous would be an example of a descriptor word.

01:20 Now look at the answer choices.

01:22 Isn't it nice to just have four options? Please write down 1, 2, 3, 4 on your scratch paper.

01:29 Pause the video.

01:31 Eliminate three of those answers and say why as you eliminate each one, then come back.

01:37 We'll walk through the question together.

01:46 Welcome back.

01:47 Okay, so we're looking for the accurate description of intravenous corticosteroid medication.

01:53 Let's start with number one.

01:55 When used for a short time, intravenous corticosteroids, it has fewer systemic side effects than using an inhaled corticosteroid.

02:05 Whoa. The pharm prof in me goes crazy when I read this, right? Because I know that is absolutely not true.

02:13 Because an IV medication has the most systemic side effects, right? You don't have to absorb the drug, it goes boom, right to work. So, that is not correct.

02:24 So number one is wrong.

02:27 It does not have fewer systemic side effects than an inhaled corticosteroid.

02:31 It's just the opposite.

02:33 And inhaled corticosteroid goes directly into the lungs before it goes into the bloodstream.

02:40 And that's the version that has the fewer systemic side effects.

02:43 So, enough about number one. But it's out.

02:46 Okay, number two.

02:49 To avoid adrenal insufficiency, intravenous corticosteroids should be used for the shortest time possible to control inflammation and an acute asthmatic attack.

03:00 Okay, so is there a relation for corticosteroids and adrenal insufficiency? Oh, yeah, because the adrenal gland is what makes the natural corticosteroids in my body, the glucocorticoids and the mineral corticoids.

03:15 So, I don't want to really suppress that adrenal gland by supplying extra corticosteroids any longer than I have to.

03:24 So that is true.

03:25 I'm going to keep it in for now and compare it to the rest of the answers.

03:30 Number three.

03:31 Intravenous corticosteroids administration may be used at the onset of seasons that provoke allergic asthma attacks to prevent acute exacerbations.

03:42 Okay. Intravenous corticosteroids that means that patient is in big trouble.

03:47 We wouldn't use this prophylactically.

03:50 We just use IV steroids for an acute attack.

03:53 So number three is not correct.

03:55 They may be on inhaled corticosteroids, maybe even oral steroids but not IV steroids just because their season is starting.

04:04 So, number three, yeah, to their.

04:07 Number four.

04:09 Intravenous corticosteroids cause an increased release of leukotrienes, histamine, and prostaglandins.

04:16 Okay, that one clearly when you're looking through that.

04:19 when leukotrienes, histamines, and prostaglandins are released, that's when your allergies go crazy.

04:26 That's a massive inflammatory response.

04:28 When you give intravenous corticosteroids, we're trying to stop that.

04:33 So no, the steroids don't cause it, the steroids treat it.

04:38 Okay, so we've eliminated one, three, and four and on this question had pretty firm beliefs about it, right? But number two.

04:45 Let's go back and make sure it makes sense with our topic.

04:49 So I'm looking for accurate descriptions of intravenous corticosteroid treatment.

04:53 How to avoid adrenal insufficiency? IV corticosteroids should be used for the shortest time possible to control inflammation in an acute asthmatic attack.

05:04 Everything about that statement is accurate.

05:07 Anytime we're using medications, we want to use it for the shortest time possible the patient would need, but particularly with IV corticosteroids because we want to avoid damaging or suppressing the adrenal gland.

05:21 Okay, now, I know it feels like we're swimming through jello.

05:28 We're moving so slow.

05:31 And we're doing that intentionally.

05:32 Most of you need to slow down in your questions.

05:36 If you will be comfortable with being uncomfortable as you sort through these answers, you're going to raise your test scores.

05:43 So eliminating answer choices and saying why will really help raise your scores.

05:49 And if you're an answer changer, you know, you can talk yourself into any one of these answers.

05:54 So stop that. Be confident in your answer.

05:58 Use your scratch paper, or your read on wipe off board, where you can solidly make up your mind, then select the right answer in an online test.

06:08 That's the best strategy.

06:10 Do not use your computer screen is a clicky, clicky, clicky, clicky, clicky, clicky to change your mind about answer choices.

06:18 That will just really make you start doubting yourself and nobody needs that in a testing situation.

06:24 So there you go.

06:26 We've got the correct answer, and we're ready to move on to the next question.