Chapter 31: Nasal Congestion and cough

Dextromethorphan works in the medulla to suppress the cough reflex.

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?

rebound congestion

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?

"Did the medication contain pseudoephedrine?"

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?

"How many times a day are you taking the medication?"

A client who takes a nasal decongestant for seasonal allergies reports dizziness and "the sensation of a fast, strong heartbeat." What assessment question should the nurse ask to best determine the possible cause of these symptoms?

Instilled into a tracheostomy Inhalation

Acetylcysteine (Mucomyst) is primarily administered by which route when being used to thin secretion? (Select all that apply.)

Advise him to avoid excessive and frequent use of the drug. Advise him not to take other OTC drugs

Mr. Johnson is prescribed pseudoephedrine to relieve his nasal congestion. What should the nurse include in patient and family education? Select all that apply.

a client with a history of coronary artery disease

Nasal decongestants would be contraindicated for which client?

a decongestant, an analgesic, and an antihistamine.

The nursing instructor is discussing over-the-counter cold remedies. According to the instructor, these products typically combine

Phenylephrine Oxymetazoline

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

Rebound congestion (rhinitis medicamentosa)

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

Oxymetazoline (Afrin)

Which is classified as a decongestant?

Jerking leg motions

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?

Sympathomimetics Topical decongestants are sympathomimetic, imitating the effects of the sympathetic nervous system to cause vasoconstriction. Pseudoephedrine has adrenergic properties. Topical decongestants are not anticholinergics or antihistamines or adrenergic antagonists.

An instructor is describing topical decongestants as belonging to which class?

Thinning respiratory secretions

Expectorants elicit their effect by which mechanism?

"I'll squeeze the bottle to get the medication up into my sinuses."

The nurse has taught a client to self-administer a topical decongestant. What statement should the nurse follow up with further education?

Oral decongestants

The nurse is providing education for a client who has begun taking an over-the-counter (OTC) combination cold medications. What is this medication most likely to contain?

Oxymetazoline

Which would the nurse expect to administer as a nasal spray?

Misuse could result in overdose.

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?

Retention of secretions

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

acetylcysteine Mucolytics, like acetylcysteine, are administered by inhalation to liquefy mucus in the respiratory tract. Solutions of mucolytic drugs may be nebulized into a face mask or mouthpiece or instilled directly into the respiratory tract through a tracheostomy. Sodium chloride solution and acetylcysteine are the only agents recommended for use as mucolytics. Guaifenesin is an expectorant. Pseudoephedrine is a nasal decongestant. Prednisone is a synthetic corticosteroid drug that is particularly effective as an immunosuppressant drug. It is used to treat certain inflammatory diseases.

The client states that he/she once needed medication to liquefy secretions in the respiratory tract. However, the client cannot recall the name of the medication but states that the medication is added to a nebulizer. The nurse suspects the client is taking which medication?

Diabetes Cardiovascular disorders Glaucoma

The nurse would caution clients with which disorders to avoid the use of over-the-counter pseudoephedrine? (Select all that apply.)

Vasoconstriction of small blood vessels of the nasal membranes

When describing the action of decongestants, a nurse integrates knowledge of this class of drugs, identifying which mechanism?

MAO inhibitors

Which of the following medications, if administered with pseudoephedrine, could increase risk of cardiac dysrhythmia?