Chapter 54

Loratadine

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?

A loss of respiratory reserve can occur.

A nurse administers an antitussive agent cautiously to a client with asthma for which reason?

Nausea and vomiting

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?

1 week

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?

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

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?

hypertension

Which condition would contraindicate the use of oxymetazoline?

ineffective airway clearance

Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine?

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

Why are second-generation H1 receptor antagonists less likely to cause less central nervous system (CNS) depression? Select all that apply.

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?

Drowsiness

A 76-year-old client has been prescribed an oral antihistamine. What adverse effect presents a priority safety concern for older adult clients?

Guaifenesin

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

30 minutes

A patient receives guaifenesin. The nurse would expect the drug to begin acting within which time frame?

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

After teaching a client who is receiving an antitussive about the drug, which statement indicates the need for additional teaching?

Obtain the client's blood pressure.

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?

Excessive salivation

The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects?

Histamine

What is the chemical mediator released in immune and inflammatory response to allergic reactions?

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?

Decreased sedation

When describing the benefits of second-generation H1 receptor antagonists to those of first-generation H1 receptor antagonists, the nurse should cite what advantage?

Meclizine

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

Benzonatate

Which agent would the nurse identify as providing local anesthesia to the respiratory passages?

"We can use the adult brand, but we just have to decrease the amount."

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?

Risk for falls related to sedation

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?

Acetylcysteine

A client is admitted after overdose with acetaminophen. What medication would the nurse expect to be administered?

Retention of secretions

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

Assess the client for health problems that may contraindicate the use of a particular remedy.

An adult client has asked the nurse to recommend an OTC cold remedy. Before making a recommendation, the nurse should implement which intervention?

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?

True

Mucolytics are often used for patients with cystic fibrosis, COPD, or tuberculosis.

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?

Pseudoephedrine

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?

"Consult with your primary care provider."

A client asks the nurse how long to use oxymetazoline (Afrin) nasal spray for nasal congestion. What is the nurse's best response?

Guaifenesin

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?

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?

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

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?

cardiovascular

A client has just been admitted for an overdose of pseudoephedrine. The nurse's assessment of the client should prioritize what system?

The client is being treated for severe hypertension.

A client informs the nurse about taking pseudoephedrine for the relief of nasal congestion due to the common cold. In which situation should the nurse suggest that the client not use this medication since it is a contraindication for this health care concern?

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

A client is instructed to take diphenhydramine after an allergic reaction. Which statement by the client indicates successful teaching concerning the safe and effective use of diphenhydramine?

Decongestants

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?

Promethazine (Phenergan) Diphenhydramine (Benadryl)

A client suffers from motion sickness. Which antihistamine would treat the client's motion sickness? (Select all that apply.)

Rebound nasal swelling

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?

Antitussives suppress coughing while expectorants loosen bronchial secretions.

A client asks, "What is the difference between antitussive medications and expectorants?" What information should the nurse's response be based upon?

Nasal steroids are contraindicated in the presence of an acute infection.

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?

"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?

Maintenance of effective airway clearance

A client is prescribed oxymetazoline, a decongestant, for the treatment of hay fever. What should the nurse evaluate to assess the efficacy of therapy?

A dry, nonproductive cough

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?

Diphenhydramine

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?

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

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.)

Blood pressure

A nurse is caring for a patient who has been prescribed a nasal decongestant. Which of the following factors should the nurse assess before administering the drug?

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

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?