Chapter 30 Upper Resp Sysytem Drug

The nurse is providing education about over-the-counter (OTC) cold remedies to a client who currently takes several medications for typical cold symptoms. What statement by the client demonstrates an understanding of risk reduction techniques associated with medication overdosing to maximize his or her safety?

"Being aware of the active ingredients in my medications is important."

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 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."

A client with asthma has been prescribed an albuterol inhaler. What recommendation should the nurse include in client teaching?

"Stop smoking to reduce bronchoconstriction."

What would be the nurse's best response if a client calls the clinic and reports that he has had a persistent cough for 2 weeks and asks the nurse for a recommendation for a cough medicine?

"You should come to the clinic to be evaluated. A cough that lasts that long might indicate a medical problem."

After reviewing information about drugs used to treat lower respiratory system conditions, a group of nursing students demonstrate understanding of the information when they identify which as an example of a short-acting beta-2 agonist (SABA)?

Albuterol

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.

A client is in the clinic to have blood drawn to assess theophylline levels. The client appears to being responding well to the medication and is not experiencing any adverse effects. What serum level will the nurse expect the client to have?

Between 10 and 20 mcg/mL

Which of the following would a nurse identify as a first generation antihistamine? Select all that apply.

Clemastine Dimenhydrinate

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

A client prescribed codeine for a persistent, debilitating cough tells the nurse, "I was sure that codeine was a narcotic that people take for pain." The nurse should cite what mechanism of action when describing this use of codeine?

Depression of the cough center in the medulla oblongata

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

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

Guaifenesin

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.

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

A 25-year-old female client presents at the clinic with bronchitis. The health care provider orders guaifenesin. Which instruction should the clinic nurse offer when teaching the client about the medication?

"Drink at least two liters of fluids each day."

A client diagnosed with the common cold asks the nurse about taking an over-the-counter (OTC) cold medications. What statement should the nurse include in client teaching?

"Follow the instructions on the label so that you don't end up making the congestion worse."

An older adult client has reported "seeing things that aren't there" after starting to take over-the-counter dextromethorphan for a nonproductive cough associated with a cold. What assessment question will provide the most relevant information regarding the possible cause of this adverse effect?

"How much dextromethorphan have you been taking each day?"

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 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."

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."

A nurse instructing a client about use of an antitussive prescription at home should also include information about increasing fluids (unless contraindicated). How much fluid should the nurse tell this client to drink each day?

1500-2000 mL

The parents of a 7-year-old client who has been diagnosed with allergic asthma are being taught about their son's medication regimen. The nurse is teaching about the appropriate use of a "rescue drug" for acute exacerbations. What drug should the nurse suggests the parents to use in these situations?

Albuterol

A nurse is assessing patients who are to be initiated with antihistamine therapy. For which of the following conditions is this therapy contraindicated? Select all that apply.

Angle-closure glaucoma Pregnancy

A client, scheduled to receive one unit of packed red blood cells, has a history of an allergic reaction to a transfusion in the past. What class of medication will assist in preventing a reaction to the packed red blood cell transfusion?

Antihistamines

A client asks, "What is the difference between antitussive medications and expectorants?" What information should the nurse's response be based upon?

Antitussives suppress coughing while expectorants loosen bronchial secretions.

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 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 has been taking an over-the-counter (OTC) cough medicine for the last 2 weeks. The client is still coughing and now complains of a headache and chest pain. This client should be instructed to do which?

Consult the primary care provider.

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 nurse is teaching a client diagnosed with asthma about the disease. Which should the nurse instruct the client to avoid because it may cause bronchoconstriction?

Extremely cold temperatures

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

Histamine

A client is encouraged to take guaifenesin to loosen the secretions due to a viral respiratory infection. What should the nurse suggest to the client to make the medication work more effectively?

Increase fluid intake

A client is prescribed salmeterol. The nurse would expect this drug to be administered by which route?

Inhalation

When teaching a client about their prescribed asthma therapy, the nurse understands that which medications may increase the risk of asthma-related death?

Long-acting beta-2 agonists

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

Mucolytic

The nurse is teaching a group of clients with allergic rhinitis about the use of their medications. What would be the most essential information to give these clients about preventing possible drug interactions?

Read drug labels before taking OTC medications.

What is an adverse reaction commonly experienced by people taking nasal decongestants?

Rebound congestion

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

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

cardiovascular

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

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

A client has a recurring problem with sinusitis every spring. The client asks the nurse if there is a herb for this problem, because the client does not like to take prescription medications. The nurse recommends which herb?

eucalyptus

Which condition would contraindicate the use of oxymetazoline?

hypertension

"I can take over-the-counter pseudoephedrine, too."

ineffective airway clearance

The nurse chooses which high priority nursing diagnoses for a client who has chronic bronchitis?

ineffective airway clearance

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

ineffective airway clearance

The nurse taking a medical history determines that the client takes a decongestant regularly for a variety of seasonal allergies. What other medication identified in the client's current medication history would constitute an immediate risk to the client's health?

monoamine oxidase inhibitor (MAOI)

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

The client calls the physician's office and is experiencing shortness of breath and the bronchodilators have not been working. The client also states being very frustrated and has missed work the past two days. The nurse identifies that the client is in which zone of her asthma action plan?

red

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

An older adult client is prescribed an antihistamine for the relief of allergic rhinitis. Which findings would the nurse likely assess in this client? Select all that apply.

sedation dry throat confusion

A 76-year-old man has a history of heart disease, and has been prescribed an oral decongestant. The nurse is concerned with this prescription because of the risk for which?

serious cardiovascular effects.

A client has been prescribed a first-generation antihistamine. What adverse effects should the nurse describe during client teaching? Select all that apply.

urinary retention blurred vision dry mouth