A nurse instructs a COPD client on using nebulized ipratropi… | MyMerci
Medical EmergenciesPA
Question
A nurse instructs a COPD client on using nebulized ipratropium. Which precaution is most important to prevent a serious adverse effect?
1Use a tight-fitting mask or mouthpiece to prevent the mist from contacting the eyes✓ Correct answer
2Drink 2 liters of water before each dose
3Take the medication on an empty stomach
4Apply ice packs to the chest during treatment
Explanation
Correct (2): Ipratropium is an anticholinergic (SAMA); aerosol contact with the eyes can cause pupil dilation and acute angle-closure glaucoma in susceptible clients. A snug mask or mouthpiece prevents drug from reaching the eyes. (1) Food timing is not relevant for inhaled use. (3,4) Unrelated.
In-depth explanation
Memory Tip Ipratropium = "Atrovent — Atro for atropine-like" anticholinergic. Avoid eye contact with mist; counsel about glaucoma symptoms (acute eye pain, halos, red eye).
Clinical scenario
Scenario 67-year-old male with COPD using ipratropium 500 mcg nebulizer QID. History of narrow-angle glaucoma. Outpatient teaching session.
Key concepts
Short-acting muscarinic antagonist (SAMA) — Ipratropium bromide; quaternary anticholinergic with minimal systemic absorption used in COPD.
Narrow-angle glaucoma — Acute angle closure risk with anticholinergic exposure; severe eye pain and vision loss.
Aerosol eye protection — Mask or mouthpiece fit minimizes ocular drug exposure during nebulizer therapy.