Respiratory Meds (agents)
What are adverse effect of Codeine
Sedation, Bradycardia, Hypotension
A patient presents to the ED for difficulty breathing. The nurse reviews the provider's orders, and understands that which medication should be administered first. A) Guaifenesin (Mucinex) B) Montelukast (Singulair) C) Ipratropium (Atrovent) D) Albuterol (Proventil)
D) Albuterol (Proventil) -> It is a bronchodilator
What is the action of Aluterol (Proventil)
Stimulates Beta 2 adrenergic receptors in smooth muscle of bronchi and bronchioles -> produce bronchodilation
Adverse effects of Benzonatate (Tessalon Perles)
Mental confusion Hallucination -> often rare
What are the goals of Histamine antagonists?
Prevent the occurrence Relieve symptoms
What is the action of guaifenesin (musinex)
Reduce the viscosity (thickness) of tenacious secretions
True or false Montelukast (singulair) helps treat asthma
TRUE
What are the adverse effect of guaifenesin (mucinex)
Urticaria (hives)
Nursing consideration with Benzonatate
- Not indicated for <10 years old - Respiratory assessment - Indicated for non-productive cough
The nurse knows Loratadine (Claritin) is A) 1st generation of histamine B) 1st generation of antihistamine C) 2nd generation of histamine D) 2nd generation of antihistamine
D) 2nd generation of antihistamine
What is the action of Loratadine (Claritin)
Blocks histamine at H1 receptors. Does not enter the CNS
What are the indication of Benzoate (Tessalon Perles)
Dry/Hacking nonproductive cough that interferes with rest and sleep
What are side effects of Codeine
Nausea, drowsniess, dizzniess, constipation, GI upset
What is the prototype of Corticosteroids?
Fluticasone (Flonase/Flovent)
What is the action of Ipratropium (Atrovent)?
Inhibits PSNS blocking action of Acetylcholine in bronchial smooth muscle. Reduces bronchoconstriction (bronchodilation)
What are the indication of Codeine
Painful/dry/hacking/nonproductive cough that interferes with sleep and rest.
What are the indication of guaifenesin (Mucinex)
Productive cough and for loosening mucus form the respiratory tract
What is the action of Codeine
Suppress cough reflect, on direct action of medulla
What is the action of Benzonatate (Tessalon Perles)
Suppress cough reflex by numbing receptors in the respiratory tract preventing cough reflex from stimulating.
True or False Antitussives is a class of medication that is subclass to Opioid and non-opioid.
TRUE It is subclass as Opioid Antitussive and Non-opioid Antitussive
What are the adverse effect of Ipratropium (atrovent)
Tachycardia Angioedema (swelling beneath skin and causes numbness)
What are some adverse effect of Fluticasone (flonase/flovent)
Tachycardia HTN (hypertenstion) mmhg higher than 139/89
Nursing consideration of Codeine
- Not indicated <4 years old - monitor sedation - Respiratory assessment - Often combines with acetaminophen in liquid suspension
What is the indication of Albuterol (Proventil)
- Prevent or treat bronchospasm, obstruct airway disease, or exercise-induced bronchospasm - Promote bronchodilation
What are the goals to treat ASthma
- Prevent/Treat acute bronchospasm - Decrease inflammation of mucus production - Reduce the frequency of asthma attacks
What are some adverse effect of Diphenhydramine (Benadryl)
- Sedation _ Paradoxical effect: excitation in children
What are some nursing consideration of Albuterol (proventil)
- Use spacer - respiratory assessment - if using two different classes inhalers, use bronchodilator first because it will help open up bronchioles and alveoli's
What are the two type of antihistamines we need to know for this unit?
Diphenhydramine (Benadryl) Loratadine (Claritin)
The nurse knows patient understands the drug Codeine when they state A) I can have alcohol in moderation with this drug B) I should take this medication on an empty stomach C) Children at <4 years old can take this medication D) I can drive and operate machinery E) I should report if my cough lasts 1> week
E) I should report if my cough lasts 1> week
True or False A nurse should give an antitussive medication to a patient who has a productive cough
FALSE -> A productive cough is d/t mucous related to inflammation in the respiratory tract. Which the nurse would want the PT to cough it out.
True or false Children >5 years of age can take Benzonatate (Tessalon Perles)
FALSE -> not indicated for <10 years old
True or False There is a cure for COPD
FALSE There is no cure. The drugs are used to reduce symptoms
What are the Side effects of Montelukast (singulair)
H/N, Cough, nasal congestion
What is the prototype of Anticholingergic?
Ipratropium (Atrovent)
What are the side effects of guaifenesin (Mucinex)
N/V/H, Drowsiness, GI upset,
What are side effects of Fluticasone (Flonase/Flovent)
Nase - Local irritation, dryness, nosebleeds Vent - Sore throat, hoarseness, oropharyngeal candidiasis (fungal infection in mouth)
What are the adverse effect of Loratadine (Claritin)
Paradoxical effect: Excitation in children
What action is H1 (histamine antagonists)
Released as a response to inflammation -> H1 blockers
What are some patient teaching when using Fluticasone (Flonase/Flovent)
Rinse mouth not a "rescue medication" Should be weaned 1 to 2 weeks if discontinued
What are the indication (treatment) of Fluticasone (flonase/Flovent)?
Nasal spray: allergies Inhaler: Chronic asthma (prevents attack's), bronchitis
What are side effects of Benzonatate (Tessalon Perles)
Nausea, Dizziness, Drowsiness
What are the subclasses for Decongestants
Adrenergic (sympathomimetics) -> Constrict blood vessels (*Pseudoephedrine - sudafed) Anticholinergics (parasympatholytic) -> Drying effects ( *Ipratropium - Atrovent) Corticosteroids -> Anti-inflammatory (*Fluticasone -Flonase/flovent)
Patient teaching for guaifenesin (Mucinex)
- Avoid alcohol - No eating or drinking for 30 mins if given in syrup/elixir - Stay hydrated (2-3 Liters/day) The increase fluid will help PT get rid of secretion - Store room temp and protect from light - report if cough >1 week - Encourage coughing and deep breath
Patient teaching of Codeine
- Avoid alcohol and using machinery or driving - Take with food - Keep it childproof - Report cough last >1 week
What are patient teaching of Loratadine (Claritin)
- Avoid alcohol - Frequent oral care d/t dry mouth - non-sedating
Adverse Effects of Albuterol (Proventil)
- CNS stimulations (nervousness) - Cardiac Stimulation (palpitations, tachycardia, Hypertension)
What are the two drugs in this unit that are used for Antitussive in respiratory.
- Codeine - Benzonatate (Tessalon Perles)
What are the side effects of Diphenhydramine (benadryl)
- Drowsiness - Anticholinergic side effects (constipation, urinary retention, dry mouth, blurred vision) -N/V
Pateint teaching of Albutrol (Proventil)
- ensure the PT know how to use inhaler - Common side effects - Rinse mouth
What are some patient teaching for Diphenhydramine (Benadryl)
- no alcohol - oral care d/t dry mouth - don't drive/operate machinery d/t sedation
Nursing consideration when using DIphenhydramine (Benadryl)
- not indicated for <2 years old - Monitor for drowsiness/sedation - administer cautiously with elderly as the side effects may be more pronounced
What are some side effects of Loratadine (Claritin)
- Headache - Anticholinergic side effects (constipation, urinary retention, dry mouth, blurred vision) - N/V
Side effects of Albuterol (Proventil)
- unusual taste in mouth after - Headache - Tremors - Insomnia - Anorexia
A client who is being treated for pruritus complains of sedation. Which medication would the nurse anticipate giving prescribed by the primary health care provider to treat this side effect? A) Loratadine B) Hydroxyzine C) Diphenhydramine D) Triamcinolone acetonide
-> It is Non-sedative A) Loratadine
What are the indication of Montelukast (singulair)
- Long-term control of asthma - decreasing the frequency of asthma attacks. - Exercise-induced bronchospasm - allergic rhinitis (hayfever aka seasonal fever)
What are the patient teaching of Montelukast (singulair)
- May be taken with or without food - Take on a consistent schedule daily, often in the evening (at least 2 hours before any exercise) - Takes 3 to 7 days before it produces therapeutic effects - Educate patient so they know it is not a "rescue" drug
What are the adverse effect of Montelukast (singulair)
- Neuropsychiatric events (hallucinations, agitation, aggression, depression) - Hepatotoxicity
What are the nursing consideration of Montelukast (singulair)
- Not "rescue" medication - Not indicated for children <1 year old - Available in granule packets, chewable tablets, tablets - Monitor Liver enzymes - Monitor behavior in patient and for increased risk of SI
What are nursing consideration of Loratadine (Claritin)
- Not indicated <2 years old - will not cause sedation
What are the indication (treatment) of Diphenhydramine (Benadryl)
- Relief of cold or allergy - Sleep disorders - Motion sickness
What are the indication of Loratadine (Claritin)
- Relief of cold or allergy symptoms - Hayfever (seasonal allergies)
What are nursing consideration when using guaifenesin (mucinex)
- Use cautiously during preg & breastfeeding - respiratory assessment - phlegm assessment (sputum culture in respiratory) - use for productive cause because we don't want mucus or phlegm to develop in PT lungs and develop to pneumonia.
A patient comes in for a physical check up. They said that they are having trouble sleeping due to a cough late at night. The patient describe it as being painful cough. The nurse knows which drug can help. A) Codeine B) Benzonatate C) Diphenhydramine D) Loratadine (Claritin)
A) Codeine -> it helps with "PAINFUL" cough
A patient is prescribed with fluticasone (flovent) after coming in for a check up. The nurse knows this medication will help with A) Asthma B) Chronic Asthma C) Emphysema D) Dysrhythmia
B) Chronic Asthma (prevents attacks) -> FLOVENT (VENT) is inhaler
A nurse is watching a nursing student administering Fluticasone (Flonase/Flovent). Which statement tells the nurse that the nursing student needs more education. A) Administering this medication to any age is okay because it help with breathing. B) Nasal spray is used for allergies and help with mucosa C) The oral inhaler is used for long-term to control asthma D) I should suggest the patient to rinse mouth after use of an inhaler to avoid candidiasis.
A) Administering this medication to any age is okay because it help with breathing. -> Not indicated for <4 years of age
A nurse knows a patient understands the drug Ipratropium (Atrovent) when the patient states. A) I should avoid caffeine when using this medication B) I should eat before taking this medication C) I should keep the drug in the fridge D) I should take this medication before bed time
A) I should avoid caffeine when using this medication
A patient comes because of shortness of breath. You hear wheezing when auscultating the patient. The nurse knows which medication will help the patient. A) Ipratropium B) Fluticasone C) Benadryl D) OTC Vicks
A) Ipratropium -> Helps with asthma (which is the part of the wheeze noise)
A patient is currently on Ipratropium (Atrovent) and says they are feeling numbness on their right arm. The nurse knows. A) This is an Adverse effect B) This is a side effect D) This is not an effect
A) This is an Adverse effect
Which instructions regarding the use of fluticasone nasal spray are appropriate for client teaching? Select all that apply. A) Use the medication on regular basis, not PRN B) Clear the nasal passages before using the medication C) Discontinue use of the medication if nasal infection develops D) Remember that driving may be dangerous because of the medication's sedative effect. E) Begin taking the medication 2 weeks before pollen season starts, and use it through the season.
A) Use the medication on regular basis, not PRN B) Clear the nasal passages before using the medication C) Discontinue use of the medication if nasal infection develops
The nurse administers albuterol to a 4 year old child. Which intervention would assist the nurse in evaluating the effectiveness of this medication? A) auscultate breath sounds B) collect sputum sample C) Conduct a neurological examination D) Palpate chest excursion
A) auscultate breath sounds
A client is prescribed albuterol to relieve severe asthma. Which adverse effects will the nurse instruct the client to anticipate? Select all that apply A) tremors B) lethargy C) Palpitations D) Bronchoconstriction E) decreased pule rate
A) tremors C) Palpitations (heart skipping beat, racing, pounding, fluttering)
Discharge teaching to a patient receiving a beta-agonist bronchodilator should emphasize reporting which side effect? A. Tachycardia B. Nonproductive cough C. Hypoglycemia D. Sedation
A. Tachycardia
What is the role of corticosteroids in the treatment of acute respiratory disorders? A. They decrease inflammation. B. They directly dilate the bronchi. C. They stimulate the immune system. D. They increase gas exchange in the alveoli.
A. They decrease inflammation.
What is the action of H2 (histamine antagonists)
Act on the GI tract -> H2 blockers
What is the action of Fluticasone (flonase/flovent)?
Anti-inflammatory - which results in decrease both congestion and bronchodilation
What is the indication (treatment) of Ipratropium (Atrovent)?
Asthma Chronic Bronchitis Emphysema (COPD)
What are some patient teaching of IPratropium
Avoid caffeine Report fever, cough, other symptoms lasting over a week Ways to combat anticholinergic side effects
The nurse knows Diphenhydramine (Benadryl) is A) 1st generation of histamine B) 1st generation of antihistamine C) 2nd generation of histamine D) 2nd generation of antihistamine
B) 1st generation of antihistamine
A patient has dry mucosa and dry mouth using Ipratropium (atrovent). The nurse knows this is. A) An adverse effect B) A side effect C) Not an effect of the drug
B) A side effect
What is a nursing consideration when administering Ipratropium (Atrovent). (select all that apply) A) Always expect dry mouth and nasal mucosa B) Administer cautiously with the elderly as the side effects may be more pronounced. C) Should not be give to kids under the age of 11 D) Often combined with albuterol for duoneb
B) Administer cautiously with the elderly as the side effects may be more pronounced. D) Often combined with albuterol for duoneb
A patient came in with shortness of breath. The provider suggest ipratropium (atrovent) for treatment. The nurse this helps with. A) Chronic Asthma B) Asthma C) Allergies D) Anti-inflammatory
B) Asthma - Chronic asthma will be used by fluticasone (flovent)
A patient comes in and says they have allergies. They are having congestion problems. What medication will be administer? A) Ipratropium B) Fluticasone C) Benadryl D) OTC Vicks
B) Fluticasone -> nasal spray
The nurse knows that patient understands the medication Loratadine (Claritin) when they state A) I can have alcohol in moderation B) I can drive or operate machinery C) I shouldn't keep frequent oral care D) I should take this medication before bed time to help me sleep
B) I can drive or operate machinery -> This drug is non-sedating
A patient is prescribed guaifenesin. The nurse understands that the purpose of the drug is to accomplish what?1 A) Treat allergic rhinitis B) Loosen bronchial secretions C) Compete with histamine receptors D) Constrict capillaries in nasal mucosa
B) Loosen bronchial secretions -> this medication is a expectorants which helps get mucus out
When a client with pneumonia is experiencing dyspnea because of difficulty expectorating thick respiratory secretion's, which action by the nurse will be most helpful? A) administer continuous oxygen B) Offer fluids at frequent intervals C) Place the client in high-fowler position D) administer prescribed steroid inhaler
B) Offer fluids at frequent intervals -> Offering fluids can help liquefy reparatory secretion's
A patient is taking Ipratropium (atrovent) and is saying that their vision is a blurry. The nurse this is. A) An adverse effect notify provider. B) Side effect of the drug C) This is not an effect of the drug and do a Snelling exam D) This is normal for this type of drug.
B) Side effect of the drug
A client who recently started receiving oral corticosteroids for a severe allergic reaction is instructed that the dosage will be reduced gradually until all medication is stopped at the end of 2 weeks. Which reason would the nurse prove for this gradual reduction in dosage? A) Discontinuing the medication too fast will cause the allergic reaction to reappear. B) Slow reduction of the medication will prevent a physiological crisis because the adrenal glands are suppressed. C) The health care provider is attempting the determine the minimal dose that will be effect for the allergy. D) Sudden cessation of the medication will cause development of serious side effects, such as moon face and fluid retention.
B) Slow reduction of the medication will prevent a physiological crisis because the adrenal glands are suppressed. ->The body's natural corticosteroid production has been suppressed during treatment. Stopping it immediately may cause Sx/S allergy to recur Cessation of medication will give the body time to adjust back to normal.
What is the action of Diphenhydramine (Benadryl)
Blocks histamine at H1 receptors. - inhibits smooth muscle constriction in blood vessels and respiratory and GI tracts; decreases capillary permeability, salvation, and tear formation
What is the action of Montelukast (singulair)
Blocks leukotriene (LT) receptors and decreases inflammation
When a client is seen in the emergency department with sudden onset severe dyspnea, coughing, and wheezes, which prescribed treatment would the nurse administer first? A) Inhaled corticosteroid B) Normal Saline Infusion C) Albuterol Per Nebulizer D) Intravenous methylprednisolone
C) Albuterol Per Nebulizer -> Albuterol is a Bronchodilator which acts within a few minutes and decreases inflammation and dilate bronchioles.
What does Tussive mean in Anti-Tussive? A) Sneeze B) Breath C) Cough D) Twitch
C) Cough Anti means against/stop/reduce
A nurse knows that the patient understands the medication Fluticasone (Flonase/Flovent) when the patients states. A) I should use this medication as "rescue medication." B) I can discontinue this medication anytime when I feel better. C) I Should rinse my mouth after using this medication D) I should use it when I wake up first thing in the morning
C) I Should rinse my mouth after using this medication
The nurse knows that the patient understands the teaching of Diphenhydramine (Benadryl) when they state. A) I can drive when taking this medication. B) I can have alcohol in moderation C) I should have frequent oral care due to dry mouth D) I should take this right before bed time
C) I should have frequent oral care due to dry mouth
Which statement tells a nurse that a patient understands the drug of Benzonatate (Tessalon Perles) A) My 9 Year old son can take this medication for his cough at night B) I should avoid machinery if I take this drug C) I should protect this medication from direct sunlight D) I can take this medication for my productive cough
C) I should protect this medication from direct sunlight
A patient present to their primary care provider to discuss itching and runny nose associated with seasonal allergies. The patient states they don't which to take anything that makes them drowsy. The nurse would anticipate the provider will order which medication. A) Montelukast (singulair) B) Diphenhydramine (Benadryl) C) Loratadine (Claritin) D) Fluticasone (Flovent)
C) Loratadine (Claritin) -> does not cause drowsiness
Which action would the nurse perform when administering fluticasone propionate to a client with asthma. Select all that apply. A) assessing the hear rate and rhythm B) Monitoring liver function blood test. C) Rinsing the oral cavity with water after use D) Obtaining blood glucose levels before meals E) Giving stool softeners to prevent constipation
C) Rinsing the oral cavity with water after use
The nurse administers albuterol to a child with asthma. Which common side effect would the nurse monitor for in the child? A) Flushing B) Dyspnea C) Tachycardia D) Hypotension
C) Tachycardia
A patient is taking fluticasone (Flonase) and complains of sore throat. The nurse knows. A) This is an adverse effect B) This is a side effect C) this is not an effect of this drug
C) this is not an effect of this drug -Fluticasone (Flonase) is administer through he nose. -Fluticasone (Flovent) will cause sore throat (is administer through inhaler)
What are side effects of Ipratropium (Atrovent)
Cough Dry mouth/Nasal Mucosa Nausea Blur vision
A child is prescribed fluticasone after an acute asthma attack. Which instruction would the nurse give the family about administration of this medication? A) Fluticasone needs to be taken with food or milk B) Fluticasone is primarily used to treat acute asthma attacks. C) The child should suck on a hard candy to help relieve dry mouth D) watch for white patches in the mouth and report to the health care provider
D) watch for white patches in the mouth and report to the health care provider - it's a steroid commonly administer by inhaler for long-term control of asthma. Oral thrust are side effects.
A client is diagnosed with a pulmonary disorder that causes COPD. Lungs tissue changes are normally reversible with this condition. The nurse understands that which is the client's most likely diagnosis? a. Asthma b. Emphysema c. Bronchiectasis d. Chronic bronchitis
a. Asthma
