AH2 - Exam 1 - Lippincott 11ed - Test 4 - Client with an Upper Respiratory Tract Infection

A nurse is teaching a client about taking antihistamines. Which of the following instructions should the nurse include in the teaching plan? Select all that apply. 1. Operating machinery and driving may be dangerous while taking antihistamines. 2. Continue taking antihistamines even if nasal infection develops. 3. The effect of antihistamines is not felt until a day later. 4. Do not use alcohol with antihistamines. 5. Increase fluid intake to 2,000 mL/day.

1, 4, 5 1. Operating machinery and driving may be dangerous while taking antihistamines. 4. Do not use alcohol with antihistamines. 5. Increase fluid intake to 2,000 mL/day. Antihistamines have an anticholinergic action and a drying effect and reduce nasal, salivary, and lacrimal gland hypersecretion (runny nose, tearing, and itching eyes). An adverse effect is drowsiness, so operating machinery and driving are not recommended. There is also an additive depressant effect when alcohol is combined with antihistamines, so alcohol should be avoided during antihistamine use. The client should ensure adequate fluid intake of at least eight glasses per day due to the drying effect of the drug. Antihistamines have no antibacterial action. The effect of antihistamines is prompt, not delayed.

The nurse should include which of the following instructions in the teaching plan for a client with chronic sinusitis? 1. Avoid the use of caffeinated beverages. 2. Perform postural drainage every day. 3. Take hot showers twice daily. 4. Report a temperature of 102°F (38.9°C) or higher.

3. Take hot showers twice daily. The client with chronic sinusitis should be instructed to take hot showers in the morning and evening to promote drainage of secretions. There is no need to limit caffeine intake. Performing postural drainage will inhibit removal of secretions, not promote it. Clients should elevate the head of the bed to promote drainage. Clients should report all temperatures higher than 100.4°F (38°C), because a temperature that high can indicate infection.

Pseudoephedrine (Sudafed) has been prescribed as a nasal decongestant. Which of the following is a possible adverse effect of this drug? 1. Constipation. 2. Bradycardia. 3. Diplopia. 4. Restlessness.

4. Restlessness. Adverse effects of pseudoephedrine (Sudafed) are experienced primarily in the car-diovascular system and through sympathetic effects on the central nervous system (CNS). The most common CNS adverse effects include restlessness, dizziness, tension, anxiety, insomnia, and weakness. Common cardiovascular adverse effects include tachycardia, hypertension, palpita-tions, and arrhythmias. Constipation and diplopia are not adverse effects of pseudoephedrine. Tachycardia, not bradycardia, is an adverse effect of pseudoephedrine.

The nurse teaches the client how to instill nose drops. Which of the following techniques is correct? 1. The client uses sterile technique when handling the dropper. 2. The client blows the nose gently before instilling drops. 3. The client uses a new dropper for each instillation. 4. The client sits in a semi-Fowler's position with the head tilted forward after administration of the drops.

2. The client blows the nose gently before instilling drops. The client should blow the nose before instilling nose drops. Instilling nose drops is a clean technique. The dropper should be cleaned after each administration, but it does not need to be changed. The client should assume a position that will allow the medication to reach the desired area; this is usu-ally a supine position.

A client with allergic rhinitis is instructed on the correct technique for using an intranasal inhaler. Which of the following statements would demonstrate to the nurse that the client understands the instructions? 1. "I should limit the use of the inhaler to early morning and bedtime use." 2. "It is important to not shake the canister because that can damage the spray device." 3. "I should hold one nostril closed while I insert the spray into the other nostril." 4. "The inhaler tip is inserted into the nostril and pointed toward the inside nostril wall."

3. "I should hold one nostril closed while I insert the spray into the other nostril." When using an intranasal inhaler, it is important to close off one nostril while inhaling the spray into the other nostril to ensure the best inhalation of the spray. Use of the inhaler is not limited to mornings and bedtime. The canister should be shaken immediately before use. The inhaler tip should be inserted into the nostril and pointed toward the outside nostril wall to maximize inhalation of the medication.

Which of the following would be an expected outcome for a client recovering from an upper respiratory tract infection? The client will: 1. Maintain a fluid intake of 800 mL every 24 hours. 2. Experience chills only once a day. 3. Cough productively without chest discomfort. 4. Experience less nasal obstruction and discharge.

4. Experience less nasal obstruction and discharge. A client recovering from an upper respiratory tract infection should report decreasing or no nasal discharge and obstruction. Daily fluid intake should be increased to more than 1 L every 24 hours to liquefy secretions. The temperature should be below 100°F (37.8°C) with no chills or diaphoresis. A productive cough with chest pain indicates a pulmonary infection, not an upper respiratory tract infection.

A client with allergic rhinitis asks the nurse what to do to decrease the rhinorrhea. Which of the following instructions would be appropriate for the nurse to give the client? 1. "Use your nasal decongestant spray regularly to help clear your nasal passages." 2. "Ask the doctor for antibiotics. Antibiotics will help decrease the secretion." 3. "It is important to increase your activity. A daily brisk walk will help promote drainage." 4. "Keep a diary of when your symptoms occur. This can help you identify what precipitates your attacks."

4. "Keep a diary of when your symptoms occur. This can help you identify what precipitates your attacks." It is important for clients with allergic rhinitis to determine the precipitating factors so that they can be avoided. Keeping a diary can help identify these triggers. Nasal decongestant sprays should not be used regularly because they can cause a rebound effect. Antibiotics are not appropriate for allergic rhinitis because an infection is not present. Increasing activity will not control the client's symptoms; in fact, walking outdoors may increase them if the client is allergic to pollen.

A nurse is completing the health history for a client who has been taking echinacea for a head cold. The client asks, "Why isn't this helping me feel better?" Which of the following responses by the nurse would be the most accurate? 1. "There is limited information as to the effectiveness of herbal products." 2. "Antibiotics are the agents needed to treat a head cold." 3. "The head cold should be gone within the month." 4. "Combining herbal products with prescription antiviral medications is sure to help you."

1. "There is limited information as to the effectiveness of herbal products." At this time, there is no strong research evidence to warrant recommendations of herbal products for management of colds; further study is needed to show evidence of therapeutic effects and indications. Antibiotics are effective against bacteria; the head cold may have a viral cause. An uncomplicated upper respiratory tract infection subsides within 2 to 3 weeks. There may be a drug-drug interaction with herbal products and prescriptions.

Guaifenesin 300 mg four times a day has been prescribed as an expectorant. The dosage strength of the liquid is 200 mg/5 mL. How many milliliters should the nurse administer for each dose? ________________ml.

Answer: 7.5 ml 300mg / X = 200mg/5ml X = 7.5ml