Drugs Acting on the Lower and Upper Respiratory Tract

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 client is instructed to take diphenhydramine (Benadryl) after an allergic reaction. Which statement by the client indicates successful teaching concerning the administration of diphenhydramine (Benadryl)?

"I should not drive my car after taking this medication."

A client reports a hacking cough. The client asks if taking an antihistamine would be helpful. The nurse's best response is:

Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough.

The nurse should complete which of the following during acute breathing distress before initiation of a broncodilator? Select all that apply:

Check blood pressure. Check pulse. Check respiratory rate

A group of students are reviewing the various drugs that affect inflammation. The students demonstrate understanding when they identify which agent as a mast cell stabilizer?

Cromolyn

Where should the nurse initially direct a client who is interested in learning more about the management of asthma?

Global Initiative for Asthma (GINA)

A client who smokes is receiving theophylline orally. Because of his history of smoking, the nurse expects the health care provider to do what with the theophylline dosing?

Increase (Nicotine from smoking interferes with the ability of the body to metabolize theophylline. Due to decreased metabolism, the dosage of theophylline would be increased.)

The triage nurse in the emergency department has a 42-year-old client with asthma present for treatment. The client's respiratory rate is 40 breaths per minute. Based on this objective data, what is the correct nursing diagnosis for this client?

Ineffective breathing pattern

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 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 cause GI upset and sedation. (The adverse effects of benzonatate include sedation, headache, dizziness, constipation, nausea, GI upset, pruritus, and nasal congestion. It is recommended that patients with cough drink plenty of fluids (1500 to 2000 mL daily) unless fluids are contraindicate due to another disease state. Benzonatate should not be crushed or chewed due to a local anesthetic effect resulting in possible choking. Consumption of alcohol while taking benzonatate can increase CNS depression and increased sedation. The maximum daily dose of benzonatate is 600 mg daily.)

A male patient is to begin treatment for pneumonia with an albuterol (Ventolin) inhaler. The nurse will advise the patient that he will most likely experience which common adverse effects of the drug?

Throat irritation

A client has been admitted to the emergency department (ED) in status asthmaticus. The ED nurse should anticipate administering which medication?

beta2 agonists in high doses

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 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 nonselectively binding to central and peripheral H1 receptors?

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 (A client who is having a blood transfusion or a diagnostic test may receive diphenhydramine, often by injection and usually as a single dose, to prevent allergic reactions. Epinephrine is the drug of choice for treating severe anaphylaxis once it has occurred. Clemastine is prescribed for allergic rhinitis and urticaria. Cetirizine is prescribed for the management of seasonal allergies.)

Codeine containing antitussives should be used cautiously in clients with which conditions? (Select all that apply.)

pregnancy, convulsive disorders, prostatic hypertrophy (Codeine-containing antitussives should be used cautiously during pregnancy, labor, COPD, acute asthma attack, preexisting respiratory disorders, acute abdominal conditions, head injury, increased intracranial pressure, convulsive disorders, hepatic or renal impairment, and prostatic hypertrophy.)

An adult client with a diagnosis of asthma has been prescribed montelukast. The nurse should teach the client that this drug will help relieve symptoms by which mechanism?

preventing the bronchoconstriction and inflammation that is caused by leukotrienes

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

They come into direct contact with nasal mucosa.

Which agents would the nurse identify as selectively and competitively blocking the receptors for the production of two substances that are components of SRSA?

Leukotriene receptor antagonists (Leukotriene receptor antagonists selectively and competitively block or antagonize receptors for the production of leukotrienes D4 and E4, components of SRSA. Xanthines are thought to work by directly affecting the mobilization of calcium within the cell by stimulating two prostaglandins, resulting in smooth muscle relaxation. Xanthines also inhibit the release of slow-reacting substance of anaphylaxis (SRSA) and histamine. Mast cell stabilizers work at the cellular level to inhibit the release of histamine (released from mast cells in response to inflammation or irritation) and inhibits the release of SRSA. Anticholinergics are used as bronchodilators because of their effect on the vagus nerve, which is to block or antagonize the action of the neurotransmitter acetylcholine at vagal-mediated receptor sites.)