A 70-year-old patient who has COPD takes theophylline daily and uses a SABA for exacerbation of symptoms.The patient reports using the SABA three or four times each week when short of breath.The patient reports feeling jittery and nauseated and having trouble sleeping.The primary care NP should:

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Nausea,vomiting,insomnia,jitteriness,and other symptoms may indicate theophylline toxicity.Serum concentration monitoring should be done whenever signs of toxicity are suspected.A serum creatinine clearance level is not indicated.Leukotriene modifiers are not used for COPD.Ipratropium is used as an adjunct to the SABA during acute exacerbations.

A 70-Year-Old Patient Who Has COPD Takes Theophylline Daily and Uses