CHAPTER 54 (DRUGS ACTING ON UPPER RESPIRATORY TRACT)

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

"Consult with your primary care provider."

A client is currently taking pseudoephedrine to help manage the nasal congestion resulting from seasonal allergies. When the client reports being extremely restless and having difficulty getting to sleep at night, what assessment question will the nurse ask to best provide interventions to minimize those effects?

"How much coffee, tea, and soda do you drink daily?"

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 nurse is teaching a 55-year-old client about fexofenadine prescribed to treat allergic symptoms. Which client statement suggests an understanding of this teaching?

"I should avoid driving after taking this medication."

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?

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

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?

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

The nurse is providing education ANTIHISTAMINESto a client who has been prescribed diphenhydramine. What information should the nurse convey to the client?

"This drug is likely to make you feel drowsy."

A client is prescribed an antitussive agent with codeine. Which statement by the client indicates that the nurse's teaching has been effective?

"This medication will cause drowsiness, and it might make me breathe slower."

The client reports a mild stinging sensation after using a nasal spray decongestant. Which response by the nurse would be most appropriate?

"This sensation is common and usually disappears with continued use."

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

30 minutes

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

Antidote for acetaminophen poisoning

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?

Blood pressure

A client having an allergic reaction to mold, describes chest tightness and difficulty breathing. Which process is occurring?

Contraction of smooth muscle in the bronchi

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

Decongestants should be used cautiously in clients with which medical conditions? Select all that apply.

Diabetes Thyroid disease Glaucoma Hypertension

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

Drowsiness

A female client is prescribed a first-generation antihistamine for her allergies. The nurse would expect her to experience what adverse effect?

Dry mouth

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

Excessive salivation

A client taking metoprolol 50 mg one tablet twice daily begins taking over-the-counter pseudoephedrine. The nurse would assess for which potential reaction? Select all that apply.

Hypertensive episode Bradycardic episode

A client who has been suffering from repeated sinus infections is diagnosed with allergic rhinitis and prescribed a daily antihistamine. What is the mechanism of action in the antihistamine medications?

It prevents histamine from acting on target tissues.

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

Which agent would the nurse instruct a client to use orally?

Pseudoephedrine

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?

Risk for falls related to sedation

When describing the effects of second-generation antihistamines, which would the nurse address as being decreased?

Sedation

Expectorants elicit their effect by which mechanism?

Thinning respiratory secretions

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

Vasoconstriction of small blood vessels of the nasal membranes

The nursing instructor is teaching about antitussives and their side effects. What ingredient found in some antitussives does the instructor tell students can cause drowsiness?

antihistamine

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

ineffective airway clearance

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.)

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

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 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

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?

Guaifenesin

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

cardiovascular

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?

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

When teaching a client about using a decongestant in a nasal spray form, which instruction would the nurse include? Select all that apply.

"Overuse can make the symptoms return." "Know that nasal burning or stinging may occur."

A client whose daily commute includes travel on a ferry boat has been prescribed diphenhydramine. During client teaching, the nurse should instruct the client to take the medication at what time?

30 to 60 minutes before the ferry trip

A patient is receiving a topical nasal decongestant. The nurse instructs the patient to stop using the drug after which length of time?

5 days

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

Guaifenesin

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

Histamine

The nurse is providing education to a client diagnosed with the common cold. What measure should the nurse recommend implementing to help liquefy cold-related secretions?

Increasing fluid intake

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?

Nausea and vomiting

A client is questioning the use of eucalyptus as a decongestant. The nurse should point out that eucalyptus is contraindicated for which clients? Select all that apply.

Pregnant females Children younger than 2 years Lactating females

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

Promethazine

A female client self-administers pseudoephedrine for relief of her symptoms associated with seasonal allergies. She phones the office reporting restlessness and insomnia. The nurse explains to the client that these are expected side effects of the medication. What is the reason for these side effects?

Pseudoephedrine produces a sympathomimetic effect.

A 62-year-old client has been prescribed an antihistamine to alleviate vasomotor rhinitis. The client reports gastric irritation after taking the tablet. Which instructions should the nurse provide to help alleviate the client's condition?

Take the tablet with food.

A male client presents to the health care provider'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.

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.

A client reports to the nurse, "My head is stuffed up and I can't breathe through my nose." Nasal discharge is noted upon examination. The client is diagnosed with a common cold. The nurse should prepare to provide medication instructions related to what classification of medication directed at the client's nasal mucosa?

decongestant

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