Chapter 31 Drug therapy for nasal congestion and cough

What statement by a 61-year-old client who is to take an antitussive with codeine indicates that the teaching has been effective?

"This medication can cause drowsiness, so I will avoid driving while I use it."

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

The nurse's assessment should prioritize what system when caring for a client who has just been admitted for an overdose of pseudoephedrine?

Cardiovascular Because pseudoephedrine is a stimulant, cardiac symptoms are a notable adverse effect, especially in the acute stage of the overdose.

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, non-productive cough. The client is diagnosed with bronchitis, and it is determined that the client needs help thinning the sputum so the cough can become productive. What does the nurse expect the health care provider will prescribe?

Guaifenesin (Mucinex) This drug is an expectorant, and it liquefies lower respiratory secretions, reducing the viscosity of the secretions and making it easier for a client to cough them up.

A 59-year-old client is unsure whether his or her symptoms are attributable to a cold or to allergies, so he/she is taking pseudoephedrine as well as an antihistamine. This combination of drugs creates a risk for what adverse effect?

Hypertension

Where does dextromethorphan work?

In the medulla to suppress the cough reflex

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

long term adverse effects of using nasal decongestants?

Rebound nasal swelling can occur with excessive or extended use of nasal sprays

Guaifenesin 200 mg PO every 4 hours as needed is ordered for a client with a respiratory ailment. The nurse understands that this medication is given for which reason?

Relief of cough

A male client is diagnosed with chronic bronchitis. What would the nurse expect to be one of his physical reports?

Retention of secretions

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.

What is a major cause of sinus infections?

inflammatory processes This movement becomes impaired when sinus openings are blocked by nasal swelling, and the impairment is considered a major cause of sinus infections. Another contributing factor is a lower oxygen content in the sinuses, which aids the growth of microorganisms and impairs local defense mechanisms.

Guaifenesin 200 mg PO every 4 hours as needed is ordered for a client with a respiratory ailment. The nurse understands that this medication is given for which reason?

relief of cough

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. Oral decongestants are contraindicated or (at minimum) used with caution in clients with severe cardiovascular disease or severe hypertension because of the risks for increased heart rate, blood pressure, and myocardial contractile force.

A client reports having difficulty finding the over-the-counter (OTC) decongestant that the client used in the past. What assessment question should the nurse ask to help address the client's concern?

"Did the medication contain pseudoephedrine?"

What home remedies are effective for mouth dryness and cough?

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

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 29-year-old female client has sinusitis, so the health care provider orders a topical nasal decongestant. What instructions should be given?

Increase fluids to 2 L per day

Acetylcysteine (Mucomyst) is primarily administered by which route when being used to thin secretion?

Instilled into a tracheostomy Inhalation

Prior to administering a mucolytic to a client what must the nurse document.

Lung sounds Amount of dyspnea Consistency of sputum

Which classification of drugs is commonly found in OTC combined cold medications?

Oral decongestants

What statement best describes how the common cold is effected by and managed using medication therapy?

The tendencies to overmedicate and use antibiotics inappropriately with the common cold are widespread and pose significant risk for complications and drug resistance.

What drugs would the pharmacology instructor tell their students may increase the effects of nasal decongestants?

Thyroid preparations

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.

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

An adverse effect that accompanies frequent or prolonged use of these drugs is a rebound congestion, officially called rhinitis medicamentosa.

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

Antidote for acetaminophen poisoning

Decongestants are available in which dosage forms?

Oral tablets Nasal sprays Nasal drops

A 43-year-old man is taking pseudoephedrine (Sudafed) for sinusitis. He calls the clinic to report that it feels like his heart is racing and that he can "feel his heart beating fast." The nurse will instruct him to:

stop taking the medication and come to the clinic as ordered by the health care provider.