Pharmacology Unit 2: Repiratory System

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

Antitussive side/adverse effects

Very few unless combined with antihistamine. Dizziness, Drowsiness, Respiratory Depression.

W/c adverse effect should the client's mother be alert for administering theophylline?

a. Drowsiness b. Irritability and restlessness c. Constipation d. Bradycardia Correct Answer: Irritability and restlessness

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

Avoid drinking alcohol while taking antihistamines

hypertension

Expectorants

improve the ability to cough up mucus from the respiratory tract. Patient might cough more.

Client who is starting fluticasone propionate salmeterol therapy should

increase weight bearing activity to minimize boneloss.

The nurse should be aware that concomitant use of what drug is contraindicated during tiotropium therapy?

ipratropium

An elderly client taking cough medicine with codeine reports dizziness when getting out of bed. This most likely can be attributed to which?

orthostatic hypotension

Antihistamines are not routinely used in the critically ill client population. Diphenhydramine, however, may be administered to a critically ill client for which reason?

prior to a blood transfusion.

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?

rebound congestion

Bronchodilators

stimulate bronchial muscles to relax, thereby expanding air passages, resulting in increased air flow.

A client, recovering from a cold and now experiencing a hacking cough, asks if taking an antihistamine would be helpful. What response demonstrates the nurse's understanding of the effective use of antihistamines? Select all that apply.

"Antihistamines are not recommended because they tend to worsen your cough." "Antihistamines are used for allergy-related coughs."

A client is in the clinic for seasonal allergic rhinitis. Loratadine (Claritin) is prescribed. Which statement will the nurse include when providing education concerning this drug?

"Determine if the drug is going to make you drowsy before you drive."

After a recent history of shortness of breath that has become increasingly severe, a woman has been prescribed ipratropium by MDI while she undergoes a diagnostic workup. What teaching should the nurse provide to this client?

"Make sure that you take this at the scheduled times, regardless of whether you feel short of breath."

Which adverse effect is associated with the use of high doses of codeine as an antitussive?

A. Diarrhea B. Nasal congestion C. Respiratory depression D. Skin rash Correct Answer: C

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

cardiovascular

When a client is sent home on acetylcysteine therapy, who normally instructs the client on the use and maintenance of the equipment and administration technique?

respiratory therapist

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 who recently starting taking over-the-counter dextromethorphan is concerned about experiencing adverse effects from the medication. Which statement(s) made by the nurse demonstrates an understanding of assessing for the most common possible effects? Select all that apply.

"Drowsiness is commonly experienced." "Are you having difficulty breathing?" "The medication can make you feel nauseous."

The nurse has finished teaching a 15-year-old client how to use an inhaler to treat asthma. What statement by the client suggests an understanding of the teaching?

"I need to shake the inhaler well before taking the medication."

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."

A client has hypertension and wants to take a nasal decongestant for cold symptoms. Which statement by the nurse indicates the effect of hypertensive medications on hypertension?

"The administration of a nasal decongestant will increase blood pressure due to vasoconstriction of blood vessels."

Salmeterol

- Bronchodilator. It can prevent asthma attacks and exercise-induced bronchospasm.

Antitussive Precautions

- Safe for children - Don't take with patients taking MAOI'S. - Use with caution in pregnant patients. - If patient has renal impairment, head injury.

Albuterol

-Bronchodilator. Causes relaxation of the bronchial smooth muscles. -Adverse reaction, tachycardia. -"rescue drug" for acute exacerbations -3 to 5 minutes between each puff

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?

A dry, nonproductive cough

Corticosteroids

A group of hormones, including cortisol, released by the adrenal glands at times of stress. Anti-inflammatory. Check: Weight, Blood Sugar and Immune System

Codeine

A narcotic drug that is commonly used for suppressing coughs. Opioid agonist.

You are caring for a client who takes a monoamine oxidase inhibitor (MAOI) for treatment of depression. The client occasionally self-administers an over-the-counter antihistamine to control allergy symptoms. What effect could this client experience as a result of combining these two medications?

Adverse effects of the antihistamine will be more severe.

Montelukast

Anti-inflammatory, Leukotriene modifier. It can treat allergies and prevent asthma attacks, but most effective if taken in the evening, once per day.

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

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

A client has begun taking an antihistamine for the treatment of seasonal allergies. What dietary guidelines should the nurse provide to the client?

Avoid drinking alcohol while taking antihistamines

When instructing the client who uses a lozenge as an antitussive, what should the nurse teach?

Avoid drinking fluids for 30 minutes after taking a lozenge.

Bronchodilator Types

Beta-blocker 1: Affect Heart Beta-blocker 2: Affect Lungs

Leukotriene Modifiers

Block receptors of leukotrienes.

The client's theophylline levels are increased when the lab results are added to the electronic health record. The nurse questions the client about his intake of which?

Coffee

The nurse is providing education to a client who has been prescribed an antiasthmatic drug. The nurse should instruct the client to avoid excessive intake of what beverage?

Coffee

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

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?

Dextromethorphan works in the medulla to suppress the cough reflex.

A client presents to the emergency department (ED) having an acute asthma attack and has been prescribed epinephrine. The nurse should assess what therapeutic effect of this drug?

Dilation of the bronchi with increased rate and depth of respiration

A nurse is describing the action of a prescribed antihistamine to a client. The nurse is describing which medication, by explaining that the drug elicits its antihistamine effects by non-selectively binding to central and peripheral H1 receptors?

Diphenhydramine

The health care provider has prescribed medication to prevent posttransfusion reaction in a client with a history of the disorder. Which medication would the nurse anticipate being administered?

Diphenhydramine

What important pre-administration assessment should the nurse conduct in a patient who has been prescribed a mucolytic drug for the treatment of upper respiratory infection?

Document amount of dyspnea

Antitussive

Drug that prevents coughing.

A client is prescribed a steroid to help decrease inflammation in their respiratory tract. When providing medication education to the client what should the nurse identify as the benefit primary benefit of administering the medication by inhaler?

Fewer systemic effects

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

Histamine

The nurse is reviewing a client's morning blood work and notes a theophylline level of 22.2 mcg/mL (123.21 µmol/L). What action should the nurse take?

Inform the health care provider that the client has toxic theophylline levels.

The nurse is providing education to a client with asthma on the therapeutic action of inhaled corticosteroid agents. How will the nurse describe the action?

Inhaled corticosteroid agents reduce airway inflammation.

A client has been diagnosed with asthma and prescribed inhaled steroids. What should the nurse teach the client about this treatment?

Inhaled corticosteroids should not be used on an emergency basis.

The nurse is caring for a client with chronic obstructive pulmonary disease. The plan of care will focus on what client problem?

Lack of patent airway

Why avoid taking guaifenesin with OTC medication?

Most otc already has guaifenesin in it.

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

Mucolytic

Expectorant Drug

Prototype - Guaifenesin (Robitussin)

Bronchodilator Drugs

Prototype— albuterol (Proventil, Ventolin) -short acting; acute relief salmeterol (Serevent diskus) -long acting; long term management

Prototype—diphenhydramine HCL (Benadryl)

Reduce histamine activity by blocking histamine receptor sites

The client with asthma has been ordered an inhaler and the nurse is teaching how to prevent Candida infections. Which would the nurse include in the instructions?

Rinse mouth with water after each use.

After teaching a group of students about topical nasal steroid decongestants, the instructor determines the need for additional teaching when the students identify which as an example?

Tetrahydrozoline

What action by the client would indicate that the client understands how to use an inhaler?

The client holds his or her breath for several seconds after compressing the canister.

A hospital client's medication administration record specifies concurrent doses of nebulized ipratropium and albuterol at 08:00 and 20:00. When administering these drugs, the nurse should base the intervention on which fact?

The two drugs can be mixed in the nebulizer immediately before administration.

The nurse provides care for numerous children with asthma. The nurse should expect to administer what drugs? Select all that apply.

-Leukotriene-receptor antagonists -Long-acting inhaled steroids -Beta-agonists

Before the nurse administers an antitussive agent, the nurse would document assessment of which information? Select all that apply.

-Vital signs -Presence of productive cough -Color and amount of sputum -Home remedies used to treat the cough

After a week, the patient returns to the student health center and states he feels better but his cough is interfering with his sleep. The Dr. now orders an antitussive for Jeff. In which situation would the use of an antitussive be inappropriate?

1. The patient's cough is interfering with eating meals. 2. The patient's cough is associated with a lung disorder. 3. The patient's cough is the source of a complication such as a rib fracture. 4. The patient's cough is irritating to the respiratory tract. Correct answer: 2

theophylline

10-20 mcg/mL. Bronchodilator. It can treat asthma and other lung problems, such as emphysema and chronic bronchitis.

The client's mother asks the nurse the purpose of offering theophylline. The nurse's best response is:

A. "This drug decreases inflammation in the bronchi." B. "Theophylline's antihistamine effect will counteract bronchospasm." C. "This drug will help to facilitate removal of secretion." D. "Theophylline dilates the bronchial tree and will make breathing easier." Correct Answer: D

Why take albuterol inhaler before taking fluticasone inhaler?

albuterol increases absorption of fluticasone.

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

Mucolytics

cut/reduce mucus. Antidote to Tylenol.

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

ineffective airway clearance