54 PU

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 Anesthetizing stretch receptors in the respiratory passages Nonselectively binding to central and peripheral H1 receptors Selectively binding to peripheral H1 receptors

Vasoconstriction of small blood vessels of the nasal membranes Vasoconstriction of small blood vessels of the nasal membranes is the mechanism of action for decongestants. First-generation antihistamines act to nonselectively bind to peripheral H1 receptors; the mechanism of action for second-generation antihistamines is to selectively bind to peripheral H1 receptors only; and peripherally acting antitussives anesthetize stretch receptors in the respiratory passages.

The nurse is providing education for a client who has been prescribed a second-generation antihistamine. Which client statement suggests a need for additional teaching? "I'll check with my health care provider to make sure that the diet supplements I'm taking are okay to take at the same time as these pills." "It's handy that I don't necessarily have to take these pills at bedtime." "I'm really hoping that these pills will cure my allergies before summer starts." "I know these can be a bit expensive, but hopefully it will be worth it for me."

"I'm really hoping that these pills will cure my allergies before summer starts."

A patient is receiving a topical nasal decongestant. The nurse instructs the patient to stop using the drug after which length of time? 3 days 6 days 4 days 5 days

5 days A topical nasal decongestant should not be used for longer than 5 days to prevent rebound congestion. Also, if the condition persists longer than 5 days, medical care should be sought.

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? Ephedrine Tetrahydrozoline Benzonatate Codeine

Codeine

When describing the benefits of second-generation H1 receptor antagonists to those of first-generation H1 receptor antagonists, the nurse should cite what advantage? Absence of adverse effects Decreased sedation Lower cost Once-weekly dosing

Decreased sedation

Which would the nurse expect to administer as a nasal spray? Benzonatate Hydrocodone Oxymetazoline Dextromethorphan

Oxymetazoline

Which is classified as a decongestant? Azelastine (Astelin) Dextromethorphan (Delsym) Oxymetazoline (Afrin) Levocetirizine (Xyzal)

Oxymetazoline (Afrin)

Some antihistamines can produce significant sedation. Which drug is most likely to cause this adverse effect? Fexofenadine Loratidine Promethazine Cetirizine

Promethazine First-generation antihistamines such as promethazine are capable of causing significant sedation. The other three drugs are second-generation antihistamines, which are less likely to cause sedation.

The nurse is providing education for a client who has been prescribed a second-generation antihistamine. Which client statement suggests a need for additional teaching? "I know these can be a bit expensive, but hopefully it will be worth it for me." "I'm really hoping that these pills will cure my allergies before summer starts." "It's handy that I don't necessarily have to take these pills at bedtime." "I'll check with my health care provider to make sure that the diet supplements I'm taking are okay to take at the same time as these pills."

"I'm really hoping that these pills will cure my allergies before summer starts." Antihistamines mitigate the signs and symptoms of allergies, but they do not cure the problem. Second-generation antihistamines are more expensive than earlier drugs. It is prudent to screen for potential interactions with herbal remedies. Because second-generation drugs do not cause sedation, they may generally be taken at any time.

A client has hypertension and wants to take a nasal decongestant for cold symptoms. Which statement by the nurse indicates the effect of hypertensive medications on hypertension?

"The administration of a nasal decongestant will increase blood pressure due to vasoconstriction of blood vessels." "The administration of nasal decongestants will increase blood pressure due to vasoconstriction of blood vessels" is indicative of good client teaching. Nasal decongestants do not cause bradycardia to increase blood pressure. The administration of nasal decongestants will not decrease thyroid production and increase blood pressure. The administration of a nasal decongestant does not act on the central nervous system.

The health care provider suggests that a client use guaifenesin to help his cough. The nurse instructs the client to call the health care provider if he continues to have a productive cough after which amount of time? 1 week 3 weeks 5 days 2 weeks

1 week Guaifenesin should not be used for more than 1 week; if the cough persists, encourage the client to seek health care

A patient receives dextromethorphan. The nurse would expect this drug to begin acting within which time frame? 15 to 20 minutes 10 to 15 minutes 25 to 30 minutes 20 to 25 minutes

25 to 30 minutes

What home remedies are effective for mouth dryness and cough? (Select all that apply.) Humidification of the environment Administration of over-the-counter antihistamine Adequate fluid intake Swishing the mouth with astringent mouthwash. Sucking on hard candy or throat lozenges

Adequate fluid intake Humidification of the environment Sucking on hard candy or throat lozenges An adequate fluid intake, humidification of the environment, and sucking on hard candy or throat lozenges can help relieve mouth dryness and cough. The use of astringent mouthwash will only increase mouth dryness.

When developing the teaching plan for a client receiving an antihistamine, which would the nurse include? (Select all that apply.) Advising the client to avoid alcohol consumption Using sugarless candies or lozenges to combat dry mouth Stopping the drug after 3 days if no relief is obtained Encouraging the client to engage in usual activities such as driving

Advising the client to avoid alcohol consumption Using sugarless candies or lozenges to combat dry mouth

A client exhibiting signs and symptoms of the common cold asks the nurse if taking an antihistamine would be helpful. What is the nurse's best response? Antihistamines are not recommended for treating a cold. Antihistamines can be helpful when they're combined with an antibiotic. Yes, but it's important to monitor for adverse effects. Yes, but be sure to use a brand that mentions 'cold remedy' on the packaging.

Antihistamines are not recommended for treating a cold. Although antihistamines are popular over-the-counter drugs, studies have demonstrated that they are not successful or recommended for the treatment of the common cold. An antibiotic should not be prescribed for the treatment of the common cold, which is a viral disorder.

An adult client has asked the nurse to recommend an OTC cold remedy. Before making a recommendation, the nurse should implement which intervention? Assess the client for health problems that may contraindicate the use of a particular remedy. Consult with a pharmacist or pharmacy technician. Assess the client's understanding of the epidemiology of the common cold and upper respiratory infections. Ensure that the client has tried some of the more common herbal and natural remedies.

Assess the client for health problems that may contraindicate the use of a particular remedy. While it is not necessary to consult with a pharmacist or pharmacy technician before recommending a particular product, the nurse needs to assess the intended recipient for conditions or other medications that contraindicate the product's use. Herbal options do not need to precede pharmaceuticals. The client's understanding of the epidemiology of the common cold is not a high priority.

When instructing a client in how to use a topical nasal spray, what would the nurse emphasize to do first? Lie down to tilt the head back. Spray the medication with the bottle upright. Clear the nasal passages. Close the opposite nares.

Clear the nasal passages.

Which agent acts directly on the medullary cough center? Tetrahydrozoline Codeine Benzonatate Ephedrine

Codeine Codeine, a centrally acting antitussive, works directly on the medullary cough center. Benzonatate provides local anesthetic action on the respiratory passages, lungs, and pleurae. Ephedrine and tetrahydrozoline are topical nasal decongestants.

A client prescribed codeine for a persistent, debilitating cough tells the nurse, "I was sure that codeine was a narcotic that people take for pain." The nurse should cite what mechanism of action when describing this use of codeine? Depression of the cough center in the medulla oblongata Desensitization of the cough receptors in the sinuses and trachea Vasodilation of the alveolar capillaries Stimulation of the reticular activating system (RAS)

Depression of the cough center in the medulla oblongata

A client presents at the clinic with a dry, nonproductive cough. The client is diagnosed with bronchitis, and it is determined that they will need help thinning sputum so that the cough can become productive. What does the nurse expect will be prescribed for the client? Aspirin Dextromethorphan Guaifenesin Codeine

Guaifenesin

A client presents at the clinic with a dry, nonproductive cough. The client is diagnosed with bronchitis, and it is determined that they will need help thinning sputum so that the cough can become productive. What does the nurse expect will be prescribed for the client? Guaifenesin Dextromethorphan Codeine Aspirin

Guaifenesin Expectorants, such as guaifenesin, are agents given orally to liquefy respiratory secretions and allow for easier removal. Dextromethorphan and codeine are antitussives used to suppress coughing.

A group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example? Guaifenesin Dextromethorphan Acetylcysteine Benzonatate

Guaifenesin Guaifenesin is an example of an expectorant. Acetylcysteine is a mucolytic. Dextromethorphan is an antitussive. Benzonatate is an antitussive.

The nursing instructor is teaching their lab students the best position for the administration of nasal sprays. What position would the instructor teach the students? Semi-Fowler's Supine Side-lying High Fowler's

High Fowler's Teach the patient to sit upright and press a finger over one nare to close it.

Mr. Zee is prescribed an inhaled nasal steroid to relieve his symptoms associated with seasonal allergies. What is true about inhaled nasal steroids? Inhaled nasal steroids do not have any adverse effects. Inhaled nasal steroids produce a significant systemic effect. Inhaled nasal steroids are used only to treat seasonal allergies. Inhaled nasal steroids are more effective than oral medications in treating the global symptoms associated with allergies.

Inhaled nasal steroids are more effective than oral medications in treating the global symptoms associated with allergies. Inhaled nasal steroidal preparations are used to treat seasonal or perennial allergic rhinitis. In fact, studies indicate that they are superior to oral antihistamines for alleviating nasal, eye, and global allergy symptoms. Common adverse effects of inhaled nasal steroids include a burning or itching sensation and a drying effect on the nasal mucosa. By delivering steroids directly to the nasal passage, inhaled nasal steroids maximize the beneficial therapeutic effects of corticosteroids while minimizing their potential systemic adverse effects, although systemic adverse effects may still occur during long-term or high-dose therapy.

A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions? Expectorant Antihistamine Peripherally acting antitussive Mucolytic Centrally acting antitussive

Mucolytic

Which would contraindicate the use of a topical nasal decongestant?

Nasal ulceration Any lesion or erosion in the mucous membranes is a contraindication because of the increased risk for systemic drug absorption. Topical nasal decongestants should be used cautiously in patients with hypertension. Topical nasal decongestants should be used cautiously in patients with diabetes. Topical nasal decongestants should be used cautiously in patients with glaucoma.

What elicits their pharmacological effect by reducing swelling in the nasal passages by vasoconstriction? (Select all that apply.) Loratadine Guaifenesin Dextromethorphan Phenylephrine Oxymetazoline

Oxymetazoline Phenylephrine Answers D and E are decongestants which reduce swelling in the nasal passages by vasoconstriction. A is an antihistamine, B is an expectorant, and C is a centrally acting antitussive.

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? Ephedrine Tetrahydrozoline Pseudoephedrine Xylometazoline

Pseudoephedrine The patient can take an oral preparation of pseudoephedrine. Xylometazoline, ephedrine, and tetrahydrozoline are usually available only in the form of nasal sprays or drops for topical use.

A client reports anxiety, restlessness, nausea, and vomiting after using a nasal decongestant. Which drug should the nurse consider as the cause for these side effects? Epinephrine Pseudoephedrine Phenylephrine Ephedrine

Pseudoephedrine The side effects of pseudoephedrine include anxiety, restlessness, nausea and vomiting. The drugs ephedrine, epinephrine, and phenylephrine do not cause these side effects. Their side effects include nasal burning, stinging, dryness, and a rebound nasal congestion.

When describing the effects of second-generation antihistamines, which would the nurse address as being decreased? Dry mouth Sedation Hypersensitivity Gastrointestinal upset

Sedation The adverse effects most often seen with antihistamine use are drowsiness and sedation. However, second-generation antihistamines are less sedating in many people. The anticholinergic effects associated with both generations include drying of the respiratory and gastrointestinal mucous membranes, gastrointestinal upset and nausea, arrhythmias, dysuria, urinary hesitancy, and skin eruption and itching associated with dryness.

When the use of antihistamines result in dryness of the mouth, the nurse should recommend which to relieve the dryness? Select all that apply. Suck on sugarless hard candy. Offer ice chips. Take frequent sips of water. Administer intravenous fluid bolus. Use a dehumidifier in the home.

Suck on sugarless hard candy. Offer ice chips. Take frequent sips of water.

The parent of a toddler asks about giving an over-the-counter (OTC) cough and cold product containing pseudoephedrine to the child. What information regarding safety and efficacy should the nurse offer? There are concerns among health professionals about how safe and effective these medications are. Risk can be minimized by using age-specific preparations of cough and cold remedies. Cough and cold remedies are generally safe and effective for children over the age of 2. Media reports about the risks of cough and cold medications in children have greatly exaggerated the risks.

There are concerns among health professionals about how safe and effective these medications are. Research seems to suggest that pseudoephedrine appears to be effective in children older than 4 years of age, but the drug's effectiveness in younger children is inconclusive. The U.S. Food and Drug Administration (FDA) does not recommend OTC use of the drug in this age group due to the risk of serious and life-threatening adverse effects, including seizures, decreased level of consciousness, tachycardia, and death. The low doses found in children's preparations may be insufficient to produce therapeutic effects. In addition, the risk of adverse effects and overdosing, particularly with liquid preparation, pose significant threats to safety. Extended-release tablets should not be administered to children younger than 12 years of age, and children should not be given drugs that are packaged for adults.

A male client presents to the health care provider's office for his annual visit. When questioned about over-the-counter medication use, he states that he uses echinacea to prevent colds. What statement is true about echinacea? He is healthier because he uses the echinacea. To be effective, echinacea must be taken daily regardless of symptoms. There is limited or no support for the use of echinacea to prevent or treat symptoms of the common cold. Echinacea is the OTC drug of choice for prevention of viral infections.

There is limited or no support for the use of echinacea to prevent or treat symptoms of the common cold. There is limited or no support for the use of dietary or herbal supplements to prevent or treat symptoms of the common cold.

A 21-year-old patient reports a mild stinging sensation on using a nasal spray containing a nasal decongestant. Which information should the nurse provide the patient? Consult the physician immediately. Dose of the medication needs reduction. This sensation usually disappears with continued use. Medication needs to be stopped immediately.

This sensation usually disappears with continued use. The nurse needs to assure the patient that the mild stinging sensation usually disappears with continued use. The drug needs to be stopped only if the stinging sensation is severe. The dose of the medication need not be altered. The physician need not be consulted immediately in the presence of a mild stinging sensation.

A group of students demonstrate understanding of topical decongestants, identifying them as: Parasympatholytics Sympathomimetics Parasympathomimetics Sympatholytics

Topical decongestants are sympathomimetics, imitating the effects of the sympathetic nervous system to cause vasoconstriction.