CH 54 drugs acting on upper resp. tract PrepU

A client asks the nurse how long to use oxymetazoline (Afrin) nasal spray for nasal congestion. What is the nurse's best response? "Use the medication until your symptoms are completely relieved." "Afrin can be used as long as nasal burning and stinging do not occur." "Over-the-counter medications are safe for long-term use." "Consult with your primary care provider."

"Consult with your primary care provider."

The nurse is reviewing a prescription for pseudoephedrine for a client experiencing nasal congestion. Which assessment question(s) should the nurse ask to confirm that the prescription is appropriate? Select all that apply. "Do you have sun-sensitive skin?" "Do you have any problems with urination?" "Do you have any history of cardiac arrhythmias?" "Are you being treated for any form of glaucoma?" "Do you consider yourself prone to anxiety or restlessness?"

"Do you have any problems with urination?" "Do you have any history of cardiac arrhythmias?" "Are you being treated for any form of glaucoma?" "Do you consider yourself prone to anxiety or restlessness?"

A client has expressed frustration stating, "I've been taking an over-the-counter (OTC) decongestant for several days and it still hasn't really cured my cold." What teaching point should the nurse convey to the client? "It usually takes between 8 and 10 days for a decongestant to cure affect cold symptoms." "Most people find that cold medications are essentially ineffective." "Sometimes a decongestant can sometimes mask the effects of your cold, essentially prolonging it." "Drugs like this can often relieve some of the symptoms of a cold, but they won't cure it."

"Drugs like this can often relieve some of the symptoms of a cold, but they won't cure it."

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? "Are you out in the sun much during a typical day?" "Are you a smoker?" "Do you tend to exercise before going to bed?" "How much coffee, tea, and soda do you drink daily?"

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

An older adult client has reported "seeing things that aren't there" after starting to take over-the-counter dextromethorphan for a nonproductive cough associated with a cold. What assessment question will provide the most relevant information regarding the possible cause of this adverse effect? "Have you been taking the dextromethorphan at bedtime?" "Have you been nauseated as well since taking the dextromethorphan?" "How much dextromethorphan have you been taking each day?" "Is the dextromethorphan making you dizzy?"

"How much dextromethorphan have you been taking each day?"

The nurse is educating an older adult client diagnosed with rhinosinusitis in an outpatient clinic about the prescribed topical oxymetazoline. The client has a history of hypertension and coronary artery disease. Which statement made by the client establishes the need for further clarification? "I will rinse the spray tip off after each use." "I will blow my nose before using the nasal spray." "I can take over-the-counter pseudoephedrine, too." "The drug is used no longer than 3 days."

"I can take over-the-counter pseudoephedrine, too."

A nurse is teaching a 55-year-old client about fexofenadine prescribed to treat allergic symptoms. Which client statement suggests an understanding of this teaching? "I should avoid driving after taking this medication." "Taking this medication shouldn't stop me from having my after-dinner drink." "It's safe to take this medication with the nighttime sinus medication that I've been using." "This medication has no serious side effects."

"I should avoid driving after taking this medication."

After teaching a client who is receiving an antitussive about the drug, which statement indicates the need for additional teaching? "I'll get a humidifier for my bedroom." "I'll keep the room warm and toasty." "I can use some lozenges for comfort." "I need to increase the amount of fluids I drink."

"I'll keep the room warm and toasty."

The nurse is caring for a client with cystic fibrosis who is receiving dornase alfa by nebulizer to help thin secretions. What statement by the client indicates a need for further instruction? "I'm glad that this medication will address all of my symptoms." "This medication will loosen up the sticky mucus that is in my lungs." "I will try to cough after I receive this medication." "I will continue to use postural drainage and take my enzymes as ordered."

"I'm glad that this medication will address all of my symptoms."

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'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'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."

The nurse is teaching a client about the potential for allergic drug reaction. What statement made by a client suggests a need for further teaching? "The additives that are in drugs can also cause allergic reactions." "All drugs have the potential to cause an allergic reaction." "Virtually any drug may induce an immunologic response in a susceptible person." "If you didn't have allergies as a child, you won't develop allergies later in life."

"If you didn't have allergies as a child, you won't develop allergies later in life."

A client is receiving dornase alfa at home. Which would the nurse instruct the client to do? "Protect the drug from light." "Mix the drug with tap water." "Take the drug orally with meals." "Store the drug at room temperature."

"Protect the drug from light."

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 cause bradycardia and increase peripheral blood pressure gastric reflux." "The administration of nasal decongestant will act on the central nervous system to cause vasodilation of blood vessels." "The administration of a nasal decongestant will decrease the thyroid production and increase blood pressure." "The administration of a nasal decongestant will increase blood pressure due to vasoconstriction of blood vessels."

"The administration of a nasal decongestant will increase blood pressure due to vasoconstriction of blood vessels."

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? 2 weeks 3 weeks 1 week 5 days

1 week

A patient receives guaifenesin. The nurse would expect the drug to begin acting within which time frame? 15 minutes 60 minutes 45 minutes 30 minutes

30 minutes

A client whose daily commute includes travel on a ferry boat has been prescribed diphenhydramine. During client teaching, the nurse should instruct the client to take the medication at what time? when the client boards the ferry the night before each trip as soon as the ferry leaves the dock 30 to 60 minutes before the ferry trip

30 to 60 minutes before the ferry trip

A client asks the nurse about using dextromethorphan to relieve a cough. What type of cough would the nurse explain is best treated with the drug? A cough that is associated with an allergy to ragweed A dry, nonproductive cough A cough that occurs when the client is exposed to airborne irritants An occasional, productive cough

A dry, nonproductive cough

A client is admitted after overdose with acetaminophen. What medication would the nurse expect to be administered? Acetylcysteine Daptomycin Darbepoetin alfa Oxymetazoline hydrochloride

Acetylcysteine

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

Adequate fluid intake Sucking on hard candy or throat lozenges Humidification of the environment

What should the client be told about nasal drops? (Select all that apply.) After using the drops keep head down and rotate it from side to side. Nasal burning or stinging may occur with the use of topical decongestants. Recline on a bed and hang your head over the edge. Do not share the container with anyone. Sniff hard for a few minutes after administration.

After using the drops keep head down and rotate it from side to side. Nasal burning or stinging may occur with the use of topical decongestants. Recline on a bed and hang your head over the edge. Do not share the container with anyone.

Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug? Treatment of bronchospasm Conversion of cardiac arrhythmias Antidote for acetaminophen poisoning Treatment of peptic ulcer disease

Antidote for acetaminophen poisoning

A client, scheduled to receive one unit of packed red blood cells, has a history of an allergic reaction to a transfusion in the past. What class of medication will assist in preventing a reaction to the packed red blood cell transfusion? Antianginals Antipyretics Antimicrobials Antihistamines

Antihistamines

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. Assess the client's understanding of the epidemiology of the common cold and upper respiratory infections. Consult with a pharmacist or pharmacy technician. 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.

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? (Select all that apply.) Using adult formulation with smaller doses Avoidance of use in children under age 2 Need to follow the directions for how often to give the drug Using household measuring devices for dosage measurements Importance of reading the label for ingredients and dosage

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

The nurse is assessing a client who is taking diphenhydramine for relief of seasonal allergies. Which finding should prompt the nurse to suspect that the resident is experiencing an anticholinergic effect of the medication? Urticaria Wheezing on expiration Blurry vision Tinnitus

Blurry vision

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

Clear the nasal passages.

Which agent acts directly on the medullary cough center? Benzonatate Ephedrine Tetrahydrozoline 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? Decreased sedation Once-weekly dosing Absence of adverse effects Lower cost

Decreased sedation

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 by relaxing the smooth muscles in the bronchioles. Dextromethorphan works by inhibiting allergen response. Dextromethorphan works on the receptors in the throat to prevent a cough. Dextromethorphan works in the medulla to suppress the cough reflex.

Dextromethorphan works in the medulla to suppress the cough reflex.

A nurse is describing the action of a prescribed antihistamine to a client. The nurse is describing which medication, by explaining that the drug elicits its antihistamine effects by non-selectively binding to central and peripheral H1 receptors? Diphenhydramine Fexofenadine Cetirizine Loratadine

Diphenhydramine

An adult client has reported experiencing a dry mouth and urinary retention after several nights of taking an over-the-counter (OTC) sleep aid. The nurse should suspect that this medication contains what antihistamine? Promethazine Olopatadine Loratadine Diphenhydramine

Diphenhydramine

The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects? Blurred vision Dry mouth Excessive salivation Drowsiness

Excessive salivation

Decongestants should be used cautiously in clients with which medical conditions? Select all that apply. Glaucoma Thyroid disease Hypertension Asthma Diabetes

Glaucoma Thyroid disease Hypertension Diabetes

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? Dextromethorphan Aspirin Guaifenesin Codeine

Guaifenesin

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

Guaifenesin

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? Supine Side-lying Semi-Fowler's High Fowler's

High Fowler's

The nurse is providing education to a client diagnosed with the common cold. What measure should the nurse recommend implementing to help liquefy cold-related secretions? Increasing fluid intake Deep breathing Reducing salt intake Gargling with normal saline

Increasing fluid intake

A group of students are reviewing information about antihistamines. The students demonstrate understanding of the information when they identify which agent as a second generation antihistamine? Loratadine Meclizine Brompheniramine Promethazine

Loratadine

A client is prescribed oxymetazoline, a decongestant, for the treatment of hay fever. What should the nurse evaluate to assess the efficacy of therapy? Maintenance of effective hydration of the skin Maintenance of effective airway clearance Maintenance of an effective urine output Maintenance of an effective heart rate

Maintenance of effective airway clearance

Which agent would a nurse expect the health care provider to prescribe for a client experiencing motion sickness? Hydroxyzine Clemastine Cyproheptadine Meclizine

Meclizine

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. The medication is not effective for croup. The medication is contraindicated for viral infections. The medication is contraindicated for the child's symptoms.

Misuse could result in overdose.

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

Mucolytic

Which would contraindicate the use of a topical nasal decongestant? Diabetes Glaucoma Nasal ulceration Hypertension

Nasal ulceration

The health care provider has ordered promethazine (Phenergan) for a client who is having a severe allergic reaction. The nurse is aware that this medication is also used to treat what condition? Central nervous system depression Hypotension Nausea and vomiting Joint pain

Nausea and vomiting

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

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

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. An antacid such as calcium carbonate. Oral nasal decongestants such as pseudoephedrine. Locally acting antitussives such as cough drops. Vitamins such as vitamin B12.

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

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

Oxymetazoline (Afrin)

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? Xylometazoline Tetrahydrozoline Ephedrine Pseudoephedrine

Pseudoephedrine

A male client presents to the health care provider's office with reports of inability to breathe freely. When the nurse reviews his use of over-the-counter medications, it is discovered that the client routinely uses nasal spray three times a day for 1 year. The nurse knows that what may be causing this client's continuous nasal congestion? Chronic nasal polyps Rebound nasal swelling Damage of the nasal concha Burning of the nares secondary to chronic use of nasal sprays

Rebound nasal swelling

A male client is diagnosed with chronic bronchitis. What would the nurse expect to be one of his physical reports? Rhinitis Retention of secretions Rhinorrhea Chronic nasal swelling

Retention of secretions

A gerontological nurse has encouraged a group of caregivers who work with older adults to avoid administering first-generation H1 receptor antagonists to their clients. The nurse's cautionary message is an acknowledgment of what possible nursing diagnosis? Risk for impaired skin integrity related to urticaria Risk for deficient fluid volume related to diuresis Risk for infection related to adverse effects of antihistamines Risk for falls related to sedation

Risk for falls related to sedation

A 62-year-old client has been prescribed an antihistamine to alleviate vasomotor rhinitis. The client reports gastric irritation after taking the tablet. Which instructions should the nurse provide to help alleviate the client's condition? Take the tablet with food. Take the tablet one hour before food. Take an antacid before the tablet. Drink ample water before taking the tablet.

Take the tablet with food.

A nurse caring for a client in the hospital is being discharged today with a prescription for benzonatate (Tessalon Perles) 200 mg one capsule 3 times daily. What would the nurse tell the client about this prescription during discharge counseling? (Select all that apply.) The client should drink plenty fluids. Benzonatate can be taken more frequently than prescribed if needed. Benzonatate capsules should be sucked on like a lozenge. Consumption of alcohol is okay while taking benzonatate. Benzonatate can cause GI upset and sedation.

The client should drink plenty fluids. Benzonatate can cause GI upset and sedation.

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? There is limited or no support for the use of echinacea to prevent or treat symptoms of the common cold. To be effective, echinacea must be taken daily regardless of symptoms. He is healthier because he uses the echinacea. 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.

Why are second-generation H1 receptor antagonists less likely to cause less central nervous system (CNS) depression? Select all that apply. They are selective for peripheral H1 receptors. They stimulate the release of catecholamines. They block the reuptake of serotonin. They have a mild inotropic effect. They do not cross the blood-brain barrier.

They are selective for peripheral H1 receptors. They do not cross the blood-brain barrier.

The nursing instructor is discussing the use of nasal decongestants and shares what reason for their effectiveness? They treat multiple symptoms in a cost-effective manner. They are absorbed systemically. They come into direct contact with nasal mucosa. Their effects last for 48 to 72 hours.

They come into direct contact with nasal mucosa.

When describing the action of decongestants, a nurse integrates knowledge of this class of drugs, identifying which mechanism? Anesthetizing stretch receptors in the respiratory passages Vasoconstriction of small blood vessels of the nasal membranes Non-selectively binding to central and peripheral H1 receptors Selectively binding to peripheral H1 receptors

Vasoconstriction of small blood vessels of the nasal membranes

The nursing instructor is teaching about antitussives and their side effects. What ingredient found in some antitussives does the instructor tell students can cause drowsiness? Advil eucalyptus antihistamine acetaminophen

antihistamine

A client reports to the nurse, "My head is stuffed up and I can't breathe through my nose." Nasal discharge is noted upon examination. The client is diagnosed with a common cold. The nurse should prepare to provide medication instructions related to what classification of medication directed at the client's nasal mucosa? antihistamine expectorant decongestant antitussant

decongestant

What medication should be prescribed to minimize the risk associated with a blood transfusion for a client with a history of a previous transfusion reaction? clemastine epinephrine diphenhydramine cetirizine

diphenhydramine

Which condition would contraindicate the use of oxymetazoline? hypertension skin rash nasal congestion cough

hypertension