Chapter 54: Drugs Acting on the Upper Respiratory Tract,

A male client asks the nurse whether antihistamines will help him cope with the symptoms of the common cold. What is the nurse's best response?

"Antihistamines do not relieve symptoms."

A male client states that he is taking medication to liquefy secretions in his respiratory tract. However, he cannot recall the name of the medication. He states that the medication is added to a nebulizer. The nurse suspects he is taking:

Mucomyst

Which would contraindicate the use of a topical nasal decongestant?

Nasal ulceration

A patient reports anxiety, restlessness, nausea, and vomiting after using a nasal decongestant. Which drug should the nurse consider as the cause for these side effects?

Pseudoephedrine

A client is receiving dornase alfa at home. Which would the nurse instruct the client to do?

"Protect the drug from light."

What should the client be told about nasal drops? (Select all that apply.)

-Recline on a bed and hang your head over the edge. -After using the drops keep head down and rotate it from side to side. -Do not share the container with anyone. -Nasal burning or stinging may occur with the use of topical decongestants.

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

30 minutes

Nasal decongestants would most likely be contraindicated for which client?

A client with a history of coronary artery disease

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

A loss of respiratory reserve can occur.

A patient is admitted to the emergency room after consuming 50 acetaminophen tablets in a suicide attempt. What medication will be administered to counteract the effect of the acetaminophen?

Acetylcysteine (Mucomyst)

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 client is taking pseudoephedrine. The nurse would assess the client for which adverse effect?

Anxiety

A male client presents to the physician's office with allergy-related symptoms that interfere with his job as a car salesman. What nasal spray does the nurse expect the physician to order?

Azelastine (Astelin)

What elicits its antihistamine effects by nonselectively binding to central and peripheral H1 receptors?

Diphenhydramine

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

Excessive salivation

A client is taking phenelzine (Nardil), a monoamine oxidase inhibitor, for depression. The client started taking dextromethorphan (Robitussin) over the counter without consulting his physician. The use of these two medications is contraindicated. Which symptoms might the patient exhibit? (Select all that apply.)

Fever Coma

Which drug is classified as an expectorant?

Guaifenesin (Robitussin)

A nurse is assigned to care for a patient who has to be administered dextromethorphan. From the patient's medical history, the nurse knows that the patient has been taking monoamine oxidase inhibitors. Which of the following effects of interaction of the two drugs should the nurse monitor for in this patient?

Hypotension, fever, nausea

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

Instilled into a tracheostomy Inhalation

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 patient 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

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

Meclizine

A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions?

Mucolytic

The physician 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 is classified as a decongestant?

Oxymetazoline (Afrin)

Some antihistamines can produce significant sedation. Which drug is most likely to cause this adverse effect?

Promethazine

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

Retention of secretions

A patient, aged 82 years, is prescribed an antihistamine for the relief of allergic rhinitis. An older age predisposes the patient to a higher risk of adverse effects. Which adverse effects is a nurse more likely to observe in the patient? (Select all that apply.)

Sedation Dryness of throat Confusion

When antihistamines result in dryness of the mouth, the nurse should recommend which actions to relieve the dryness? Select all that apply.

Suck on sugarless hard candy. Offer ice chips. Take frequent sips of water.

A group of students demonstrate understanding of topical decongestants, identifying them as:

Sympathomimetics

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.

Expectorants elicit their effect by which mechanism?

Thinning respiratory secretions

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

While using a decongestant, a client should be instructed to call the physician if which occur? (Select all that apply.)

-Symptoms do not improve in seven days. -A high fever develops.

what are common upper respiratory disorders?

-infections -allergic rhinitis -coughs -the common cough -congestion

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?

1 week

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

25 to 30 minutes

what is the purpose/ mechanism of the respiratory system?

to exchange oxygen and carbon dioxide in the lungs

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

When describing the action of dornase alfa in treating cystic fibrosis, the nurse understands that this drug:

Separates extracellular DNA from protein in mucus

difference between the 1st and 2an generation histamine

- 1st generation bind non-selectivity to central and peripheral H1 receptors and many result in CNS stimulation or depression -2nd generation are selective for peripheral H1 receptors and as a group are less sedating

A female client administers diphenhydramine to her 9-year-old male child, who experiences seasonal allergies, before his first baseball game. What may the child experience if he has a paradoxical effect to the medication?

Decreased mental alertness

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

Diabetes Cardiovascular disorders Glaucoma

Decongestants are available in which dosage forms? (Select all that apply.)

Oral tablets Nasal sprays Nasal drops

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

Pregnancy Convulsive disorders Prostatic hypertrophy

A male client presents to the physician's office for his annual visit. When questioned about over-the-counter medication use, he states that he uses Echinacea to prevent colds. What statement is true about Echinacea?

There is limited or no support for the use of Echinacea to prevent or treat symptoms of the common cold.

what are three types of histamines

1) H1- contract smooth muscle and dilate capillaries 2) H2- heart rate and gastric secretions increase when activated 3) receptor located throughout the nervous system

A 45-year-old female client is being seen in the physician's office for a dry, hacking cough that is keeping her up at night. The physician prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan?

Dextromethorphan works in the medulla to suppress the cough reflex.

what are the interventions of comfort measure for patient with viral condition

-antihistamines to relieve allergy symptoms -decongestants to reduce nasal edema antitussives, mucolytic, and expectorants to treat accompanying cough