1905 ch 31 drug therapy for nasal congestion and cough

A 25-year-old female client presents at the clinic with bronchitis. The health care provider orders guaifenesin. Which instruction should the clinic nurse offer when teaching the client about the medication?

"Drink at least two liters of fluids each day."

A client who takes a nasal decongestant for seasonal allergies reports dizziness and "the sensation of a fast, strong heartbeat." What assessment question should the nurse ask to best determine the possible cause of these symptoms?

"How many times a day are you taking the medication?"

Which statement by the client would alert the nurse that more education is needed regarding a client receiving an antitussive?

"I should keep the room warm."

The nurse is discussing the use of pseudoephedrine with parents of children of various ages. What statement made by a parent demonstrates an understanding of the safe administration of a decongestant?

"Only my children who are 12 years of age or older can be given the extended-release form of pseudoephedrine."

A client diagnosed with the common cold expresses interest in taking echinacea. What information is most appropriate for the nurse to provide?

"There's no evidence that echinacea is effective in treating the cold."

A male college student has presented to the campus medical clinic reporting cold symptoms that he has been experiencing for the past 2 weeks. He tells the nurse that he has been taking OTC decongestants twice daily since the onset of the cold. What teaching point should the nurse provide to this student?

"You might find yourself more congested than ever as your body compensates for your use of these drugs."

Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug?

Antidote for acetaminophen poisoning

A parent asks the nurse about the use of an antitussive to treat a 7-year-old's dry cough. What principle should guide the nurse's response?

Antitussives are not recommended for use in young children.

A client asks, "What is the difference between antitussive medications and expectorants?" What information should the nurse's response be based upon?

Antitussives suppress coughing while expectorants loosen bronchial secretions.

A nurse is preparing a presentation for a local elementary school parent group about over-the-counter cold medications and their use in children. Which would be most appropriate to include?

Avoidance of use in children under age 2 Importance of reading the label for ingredients and dosage Need to follow the directions for how often to give the drug

A client is prescribed oxymetazoline. Which assessment data would indicate that the drug is effective?

Breathing pattern is regular and without difficulty.

When instructing a client in how to use a topical nasal spray, what would the nurse emphasize to do first?

Clear the nasal passages.

Which agent acts directly on the medullary cough center?

Codeine

A 45-year-old female client is being seen in the health care provider's office for a dry, hacking cough that is keeping her up at night. The provider prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan?

Dextromethorphan works in the medulla to suppress the cough reflex.

A client presents at the clinic with a dry nonproductive cough. The client is diagnosed with bronchitis, and it has been determined that assistance is needed in thinning the sputum so the cough can become productive. What does the nurse expect the provider will prescribe?

Guaifenesin

A 29-year-old client has sinusitis and has been prescribed a topical nasal decongestant. What instructions should the nurse provide?

Increase fluids to 2 L/d.

Which of the following medications, if administered with pseudoephedrine, could increase risk of cardiac arrhythmia?

MAO inhibitors

A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions?

Mucolytic

An older adult client diagnosed with hypertension and cardiac disease is experiencing a cold. The client asks the nurse what medications the client can take. Which groups of medications should the nurse suggest? Select all that apply.

Oral expectorants such as guaifenesin. Locally acting antitussives such as cough drops.

Which is classified as a decongestant?

Oxymetazoline (Afrin)

What is an adverse reaction commonly experienced by people taking nasal decongestants?

Rebound congestion

Cough syrups serve as vehicles for antitussive drugs and also may exert antitussive effects of their own by doing what?

Soothing irritated pharyngeal mucosa

An instructor is describing topical decongestants as belonging to which class?

Sympathomimetics

A client informs the nurse about taking pseudoephedrine for the relief of nasal congestion due to the common cold. In which situation should the nurse suggest that the client not use this medication since it is a contraindication for this health care concern?

The client is being treated for severe hypertension.

The nursing instructor is discussing the use of nasal decongestants and shares what reason for their effectiveness?

They come into direct contact with nasal mucosa.

Expectorants elicit their effect by which mechanism?

Thinning respiratory secretions

A client visits the clinic and is diagnosed with acute sinusitis. To promote sinus drainage, what medication might be ordered?

Topical decongestants

A client is diagnosed with a viral upper respiratory tract infection. Which of the following is appropriate treatment for the client? Select all that apply:

Use of antitussive for nonproductive cough. Use of comfort measures. Increase of fluid intake.

When describing the action of decongestants, a nurse integrates knowledge of this class of drugs, identifying which mechanism?

Vasoconstriction of small blood vessels of the nasal membranes

While reviewing the medication histories, the nurse notices that several clients regularly take over-the-counter dextromethorphan. Which client does the nurse recognize as having an increased risk for developing an adverse reaction to dextromethorphan based on his or her medical diagnosis and medication therapy?

an adult diagnosed with chronic depression being treated with a selegiline

The nurse is planning care for a client who is experiencing excessive respiratory tract secretions. What intervention should the nurse include?

deep breathing and coughing exercises

The nursing instructor is teaching students about the administration of nasal sprays. According to the instructor, the correct patient position for administering the sprays is closest to

high Fowler's position.

Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine?

ineffective airway clearance

The nurse is providing education to a client who has been diagnosed with a sinus infection. What would the nurse identify as a major cause of this disorder?

inflammatory processes

The nurse taking a medical history determines that the client takes a decongestant regularly for a variety of seasonal allergies. What other medication identified in the client's current medication history would constitute an immediate risk to the client's health?

monoamine oxidase inhibitor (MAOI)

A 76-year-old man has a history of heart disease, and has been prescribed an oral decongestant. The nurse is concerned with this prescription because of the risk for which?

serious cardiovascular effects.

The instructor is teaching about the use of mucolytics. The nursing student demonstrates an understanding of the action of the mucolytic drugs when stating which?

they are used to break down the thickness of secretions.

A client is currently taking pseudoephedrine to help manage the nasal congestion resulting from seasonal allergies. When the client reports being extremely restless and having difficulty getting to sleep at night, what assessment question will the nurse ask to best provide interventions to minimize those effects?

"How much coffee, tea, and soda do you drink daily?"

A nurse is assigned to care for a client who is prescribed dextromethorphan. The client's history reveals that the client is also taking a monoamine oxidase inhibitor for depression. The nurse would assess the client for which effect?

Jerking leg motions

A patient is advised to take a decongestant drug to relieve nasal congestion associated with hay fever. The patient is not comfortable with a nasal spray or drops and prefers an oral tablet. Which oral decongestant drugs can be administered to the patient?

Pseudoephedrine

The nurse is giving discharge instructions to a client with an upper respiratory infection who has been advised to take an over-the-counter (OTC) topical nasal decongestant. What should the nurse teach the client in order to prevent rhinitis medicamentosa?

Use the medication for as short a time as possible.

The nursing instructor is discussing over-the-counter cold remedies. According to the instructor, these products typically combine

a decongestant, an analgesic, and an antihistamine.

The client with bilateral pneumonia has been prescribed a mucolytic. The nurse correctly identifies a mucolytic as having which action?

a drug that breaks down thick, tenacious mucus in the lower portions of the lungs

A female client calls the pediatrician's office for a suggestion regarding the best over-the-counter cough and cold medicine for her 6-month-old child. The pediatrician advises against the medication for what reason?

Misuse could result in overdose.