Pharmacology II Prep U Chapter 54: Drugs Acting on the 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 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 I will not drive."

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?

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

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

30 minutes

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

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

A loss of respiratory reserve can occur.

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

Antidote for acetaminophen poisoning

A client reports a hacking cough. The client asks if taking an antihistamine would be helpful. The nurse's best response is:

Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough.

Second generation antihistamines are associated with a higher risk of sedation than first generation antihistamines.

False

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.

Which condition would contraindicate the use of or oxymetazoline?

hypertension

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."

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

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

A client is prescribed oxymetazoline. Which assessment data would indicate that the drug is effective?

Breathing pattern is regular and without difficulty.

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

Drowsiness

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

Excessive salivation

A female client presents at the clinic with a dry, nonproductive cough. The client is diagnosed with bronchitis, and it is determined that she will need help thinning sputum so that the cough can become productive. What does the nurse expect will be prescribed for the client?

Guaifenesin

When describing the action of acetylcysteine in treating cystic fibrosis, which would the nurse need to keep in mind about the drug?

It splits the disulfide bonds that hold mucus together.

A client 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

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?

Obtain the client's blood pressure.

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

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

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 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

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.

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

True

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

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

contraction of smooth muscle in the bronchi

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?

diphenhydramine

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

histamine

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

To help liquefy cold-related secretions, the nurse should encourage the client to implement which measure?

increasing fluid intake

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

ineffective airway clearance

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?

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

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.

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

Mucolytic

When developing the teaching plan for a client receiving an antihistamine, which would the nurse include? (Select all that apply.)

• Advising the client to avoid alcohol consumption • Using sugarless candies or lozenges to combat dry mouth

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

Guaifenesin

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

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

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

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

When providing health education to an adult who is taking an over-the-counter (OTC) combination cold and cough remedy, the nurse should encourage the client to implement what intervention to best assure medication safety?

Carefully read the label and adhere to the guidelines for use.

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

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.

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

• Phenylephrine • Oxymetazoline

Katie, 14 years old, is seen by the health care provider due to increased nasal congestion and a sore throat lasting 2 days. Katie reports to the provider that every fall at this time she has increased nasal congestion and pressure. Upon examination, the provider notes enlarged turbinates with excessive mucus in the nose and at the back of the throat and a reddened throat. The provider prescribes pseudoephedrine. Why is Katie being prescribed this medication?

To provide relief of the nasal congestion

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

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

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