Ch 54 Prep U
A client asks the nurse how long to use oxymetazoline (Afrin) nasal spray for nasal congestion. What is the nurse's best response?
"Consult with your primary care provider."
A patient receives dextromethorphan. The nurse would expect this drug to begin acting within which time frame?
25 to 30 minutes
The nurse instructs a client who is prescribed a nasal steroid that it may take up to how long before effects may be noted?
7 days
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 dry, nonproductive cough
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?
Antihistamines
A client has self-medicated with an over-the-counter (OTC) decongestant nasal spray for several weeks in order to help prevent "getting the common cold." The nurse should educate the client concerning the risk for which result(s) of long-term use of OTC cold remedies? Select all that apply.
Chronic nasal congestion Damage to the nasal mucosa
A client having an allergic reaction to mold, describes chest tightness and difficulty breathing. Which process is occurring?
Contraction of smooth muscle in the bronchi
Which would contraindicate the use of a topical nasal decongestant?
Nasal ulceration
A male client is diagnosed with chronic bronchitis. What would the nurse expect to be one of his physical reports?
Retention of secretions
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
A client reports experiencing severe nasal congestion since starting to use an over-the-counter (OTC) nasal decongestant spray a week ago. This symptomology most supports what possible medical condition?
rebound congestion
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?
"How much dextromethorphan have you been taking each day?"
The nurse is caring for a client who has been diagnosed with cystic fibrosis and is receiving dornase alfa by nebulizer to help thin secretions. What statement by the client indicates a need for further instruction?
"I'm glad this medication will address all of my symptoms."
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?
"If you didn't have allergies as a child, you won't develop allergies later in life."
The nurse is educating an adult client diagnosed with rhinosinusitis with viscous clear mucous about the prescribed guaifenesin 400 mg PO every 4 hours. Which statement made by the client establishes the need for further clarification?
"The drug will suppress my cough so I can sleep easier."
A patient receives guaifenesin. The nurse would expect the drug to begin acting within which time frame?
30 minutes
Mr. Johnson is prescribed pseudoephedrine to relieve his nasal congestion. What should the nurse include in patient and family education? Select all that apply.
Advise him to avoid excessive and frequent use of the drug. Advise him not to take other OTC drugs.
Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug?
Antidote for acetaminophen poisoning
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.
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 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.)
Benzonatate can cause GI upset and sedation. The client should drink plenty fluids.
A critically ill client with a diagnosis of ventilator-associated pneumonia has been administered acetylcysteine. The inhalation of acetylcysteine helps to liquefy secretions in the respiratory tract by what mechanism?
Breaking the protein bonds that exist in mucus
A client is prescribed oxymetazoline. Which assessment data would indicate that the drug is effective?
Breathing pattern is regular and without difficulty.
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
What is the chemical mediator released in immune and inflammatory response to allergic reactions?
Histamine
A client has been prescribed a nasal steroid. The client asks the nurse about the infection that the nasal steroid has been prescribed for. What would be an appropriate response by the nurse?
Nasal steroids are contraindicated in the presence of an acute infection.
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?
Nausea and vomiting
Which agent would the nurse instruct a client to use orally?
Pseudoephedrine
Expectorants elicit their effect by which mechanism?
Thinning respiratory secretions
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
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?"
After teaching a client who is receiving an antitussive about the drug, which statement indicates the need for additional teaching?
"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."
After teaching a group of parents about the use of over-the-counter cough and cold products with their children, which statement indicates the need for additional teaching?
"We can use the adult brand, but we just have to decrease the amount."
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.)
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 experiencing allergy symptoms after being exposed to environmental dust. This reaction involves the action of histamine, which is released by what cells?
Basophils
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
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
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.
The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects?
Excessive salivation
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
What effect is associated with a first-generation H1 receptor antagonist?
It decreases capillary permeability.
When describing the action of acetylcysteine in treating cystic fibrosis, which would the nurse need to keep in mind about the drug?
It splits the disulfide bonds that hold mucus together.
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
Which agent would a nurse expect the health care provider to prescribe for a client experiencing motion sickness?
Meclizine
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?
Rebound nasal swelling
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.
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.
An elderly client is prescribed diphenhydramine for allergic response to mold. What should be the focus of the nursing assessment for the client?
anticholinergic effects
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?
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?
decongestant
A client reports taking pseudoephedrine to relieve nasal congestion. The nurse would instruct the client to stop using the medication if what disorder is documented in the client history?
history of coronary artery disease
Which condition would contraindicate the use of oxymetazoline?
hypertension
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?
"Drugs like this can often relieve some of the symptoms of a cold, but they won't cure it."
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 cla
"I can take over-the-counter pseudoephedrine, too."
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 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."
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."
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."
A client comes to the clinic with what appears to be a cold. What group of upper respiratory drugs cause local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow?
Decongestants
A client calls the clinic and reports symptoms of a cold. The client is most concerned because the cold symptoms are preventing him from sleeping. The nurse would inform the client that what medication relieves cold symptoms and aids sleep?
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?
Diphenhydramine
The use of centrally acting antitussives, such as codeine, increases the risk for injury related to which condition(s)? Select all that apply.
Drowsiness Dizziness
A group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example?
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?
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
The physician has order promethazine (Phenergan) for a client who is nauseated and vomiting. Which would be an appropriate route of administering promethazine to the client? (Select all that apply.)
Intramuscularly Intravenously
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
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 airway clearance
Pseudoephedrine (Sudafed) is prescribed for a client suffering from nasal and sinus congestion. What is the most important assessment the nurse should complete before the client leaves the clinic to purchase the medication?
Obtain the client's blood pressure.
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 falls related to sedation
A client has just been admitted for an overdose of pseudoephedrine. The nurse's assessment of the client should prioritize what system?
cardiovascular
The nurse reviews the client's medical history before providing medications. Which antihistamine would the nurse question before providing a dose to the client?
diphenhydramine
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?
diphenhydramine
Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine?
ineffective airway clearance
What home remedies are effective for mouth dryness and cough? (Select all that apply.)
Adequate fluid intake Humidification of the environment Sucking on hard candy or throat lozenges
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.
Which is classified as a decongestant?
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?
Pseudoephedrine
A female client self-administers pseudoephedrine for relief of her symptoms associated with seasonal allergies. She phones the office reporting restlessness and insomnia. The nurse explains to the client that these are expected side effects of the medication. What is the reason for these side effects?
Pseudoephedrine produces a sympathomimetic effect.
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.
