Chapter 31 Prep U

Decongestants should be used cautiously in clients with which conditions? (Select all that apply.) Diabetes Glaucoma Hypotension Hypothyroidism Arthritis

Diabetes Glaucoma

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

Guaifenesin

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

Guaifenesin

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? Dilute the liquid medication with water prior to administration Increase fluid intake Take the medication with food Take the medication with other over-the-counter medications to enhance the effect

Increase fluid intake

A client has been prescribed an antitussive. The nurse prepares to assess which factors on the ongoing assessment? Select all that apply. Heart sounds Lung sounds Frequency of cough Therapeutic effect Pain assessment

Lung sounds Frequency of cough Therapeutic effect Pain assessment

The nurse is providing education to a client who has been prescribed a nasal spray. What information is most important to include in this discussion? Finish the bottle of nasal spray to clear the infection effectively. Nasal spray can be shared between family members. Administer the nasal spray in a prone position. Overuse of nasal spray may cause rebound congestion.

Overuse of nasal spray may cause rebound congestion.

A client suffers from motion sickness. Which drug would the nurse anticipate the primary health care provider to prescribe? Select all that apply. Promethazine Diphenhydramine Levocetirizine Azelastine Pseudoephedrine

Promethazine Diphenhydramine

What is an adverse reaction commonly experienced by people taking nasal decongestants? Diarrhea Rebound congestion Rash Headache

Rebound congestion

The nurse is preparing a teaching session for a client with rhinitis about the prescribed decongestant. Which potential adverse reaction should the nurse point out? Decreased pulse rate Blurred vision Drowsiness Dryness of throat

Blurred vision

The nurse is providing health education to an adult client who is taking an over-the-counter combination cold and cough remedy. What guidance should the nurse include to best assure medication safety? Carefully read the label and adhere to the guidelines for use. Stop taking the medication until you get a prescription from your primary health care provider. Start with a low dose and gradually increase it until symptoms are relieved. Take the medication with an additional dose of acetaminophen to potentiate therapeutic effects.

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

Which agent acts directly on the medullary cough center? Benzonatate Codeine Ephedrine Tetrahydrozoline

Codeine

A client comes to the clinic with what appears to be a cold. What group of upper respiratory drugs cause local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow? Antitussives Decongestants Expectorants Mucolytics

Decongestants

A client reports having difficulty finding the over-the-counter (OTC) decongestant that the client used in the past. What assessment question should the nurse ask to help address the client's concern? "Would you like your health care provider to prescribe something for congestion?" "How long has it been since you last needed to take a decongestant?" "Have you asked the pharmacist about a substitute medication?" "Did the medication contain pseudoephedrine?"

"Did the medication contain pseudoephedrine?"

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? "Use a second method of contraception until you've completed the drug therapy." "Drink at least two liters of fluids each day." "Restrict your fluid intake to one liter each day." "Take an NSAID to relieve the joint aches that result from taking this 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? "You should really consider prescription medications rather than OTC medications." "While OTC medications may be cheaper, they generally result in more side effects." "Follow the instructions on the label so that you don't end up making the congestion worse." "No OTC medication, especially sprays or nose drops, should be taken for more than 3-4 days."

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

A client is currently taking pseudoephedrine to help manage the nasal congestion resulting from seasonal allergies. When the client reports being extremely restless and having difficulty getting to sleep at night, what assessment question will the nurse ask to best provide interventions to minimize those effects? "Do you tend to exercise before going to bed?" "Are you a smoker?" "Are you out in the sun much during a typical day?" "How much coffee, tea, and soda do you drink daily?"

"How much coffee, tea, and soda do you drink daily?"

A client diagnosed with the common cold expresses interest in taking echinacea. What information is most appropriate for the nurse to provide? "There's no evidence that echinacea is effective in treating the cold." "Formulations that include vitamin C are the most effective." "Be sure to use the brand recommended by your pharmacist." "Echinacea use has been associated with loss of smell."

"There's no evidence that echinacea is effective in treating the cold."

The client reports a mild stinging sensation after using a nasal spray decongestant. Which response by the nurse would be most appropriate? "You need to stop the medication immediately." "The dose is probably too strong and needs to be reduced." "This sensation is common and usually disappears with continued use." "We better contact your primary health care provider right away."

"This sensation is common and usually disappears with continued use."

A client prescribed an antihistamine for vasomotor rhinitis is concerned about the potential increased sedation effects. Which antihistamine can the nurse point out as the best option to help avoid the sedation effects? Brompheniramine Clemastine Chlorpheniramine Azelastine

Azelastine

A male client is diagnosed with chronic bronchitis. What would the nurse expect to be one of his physical reports? Rhinitis Rhinorrhea Retention of secretions Chronic nasal swelling

Retention of secretions

A male client presents to the health care provider's office for his annual visit. When questioned about over-the-counter medication use, he states that he uses echinacea to prevent colds. What statement is true about echinacea? Echinacea is the OTC drug of choice for prevention of viral infections. There is limited or no support for the use of echinacea to prevent or treat symptoms of the common cold. To be effective, echinacea must be taken daily regardless of symptoms. He is healthier because he uses the echinacea.

There is limited or no support for the use of echinacea to prevent or treat symptoms of the common cold.

The instructor is teaching about the use of mucolytics. The nursing student demonstrates an understanding of the action of the mucolytic drugs when stating which? They are used to relieve a nonproductive cough. They are used to break down the thickness of secretions. They are used to relieve a productive cough. They are used to depress the cough center in the medulla.

They are used to break down the thickness of secretions.

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 Selectively binding to peripheral H1 receptors Non-selectively binding to central and peripheral H1 receptors Anesthetizing stretch receptors in the respiratory passages

Vasoconstriction of small blood vessels of the nasal membranes

The nursing instructor is discussing over-the-counter cold remedies. According to the instructor, these products typically combine an antihistamine, a stimulant, and a decongestant. a stimulant, a decongestant, and an antitussive. a decongestant, an analgesic, and an antihistamine. an analgesic, an antitussive, and an antiviral.

a decongestant, an analgesic, and an antihistamine.

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

cardiovascular

The nurse is planning care for a client who is experiencing excessive respiratory tract secretions. What intervention should the nurse include? deep breathing and coughing exercises administration of pseudoephedrine supplemental oxygen administration of guaifenesin

deep breathing and coughing exercises

The nursing instructor is teaching students about the administration of nasal sprays. According to the instructor, the correct patient position for administering the sprays is closest to supine. semi-Fowler's position. high Fowler's position. side-lying position.

high Fowler's position.

The nurse is providing education to a client who has been diagnosed with a sinus infection. What would the nurse identify as a major cause of this disorder? autoimmune processes facial pain impaired blood supply inflammatory processes

inflammatory process

The nurse is providing education to a client who has been diagnosed with a sinus infection. What would the nurse identify as a major cause of this disorder? autoimmune processes facial pain impaired blood supply inflammatory processes

inflammatory processes

A client is prescribed dextromethorphan for a persistent cough. For which drug category would the nurse question giving the antitussive to the client? diuretic beta blocker cardiac glycoside monoamine oxidase inhibitor (MAOI)

monoamine oxidase inhibitor (MAOI)

A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions? Mucolytic Centrally acting antitussive Expectorant Peripherally acting antitussive Antihistamine

mucolytic

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? a drug allergy bronchitis sinusitis rebound congestion

rebound congestion

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?" "Would you say you are experiencing heart palpations?" "There have been reports associating dextromethorphan and visual hallucinations." "The medication can make you feel nauseous."

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

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? "Have you been nauseated as well since taking the dextromethorphan?" "Have you been taking the dextromethorphan at bedtime?" "How much dextromethorphan have you been taking each day?" "Is the dextromethorphan making you dizzy?"

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

What statement by a client who is to take an antitussive with codeine indicates the nurse's teaching has been effective? "I will take this medication anytime I start to cough." "This medication may make me anxious and nervous." "I will call my primary health care provider if I have diarrhea." "This medication can cause drowsiness, so I will not drive after I take it."

"This medication can cause drowsiness, so I will not drive after I take it."

What statement by a client who is to take an antitussive with codeine indicates the nurse's teaching has been effective? "This medication can cause drowsiness, so I will not drive after I take it." "I will take this medication anytime I start to cough." "I will call my primary health care provider if I have diarrhea." "This medication may make me anxious and nervous."

"This medication can cause drowsiness, so I will not drive after I take it."

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 over-the-counter products for our 5-year-old but not for our 18-monthold." "We need to read the label carefully to see how often and how much to give." "We can use the adult brand, but we just have to decrease the amount." "We should use the cup that comes with the drug to measure it out."

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

A male college student has presented to the campus medical clinic reporting cold symptoms that he has been experiencing for the past 2 weeks. He tells the nurse that he has been taking OTC decongestants twice daily since the onset of the cold. What teaching point should the nurse provide to this student? "It's best to take small doses of decongestants several times daily rather than two larger doses each day." "You can probably expect to get relief within the next few days or a week at the longest." "Over-the-counter decongestants don't normally work; you'll likely need to get a prescription for something more effective." "You might find yourself more congested than ever as your body compensates for your use of these drugs."

"You might find yourself more congested than ever as your body compensates for your use of these drugs."

A client calls the clinic and states, "I have had a persistent cough for 2 weeks. What should I do?" What would be the nurse's best response? "Look for dextromethorphan as an ingredient in any over-the-counter cough preparation." "You probably need an antihistamine to dry up your secretions and stop the cough." "You should come to the clinic to be evaluated. A cough that lasts that long might indicate a medical problem." "Drink a lot of fluids and take an aspirin, which should reduce the irritation in your throat."

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

What home remedies are effective for mouth dryness and cough? (Select all that apply.) Administration of over-the-counter antihistamine Adequate fluid intake Humidification of the environment Sucking on hard candy or throat lozenges Swishing the mouth with astringent mouthwash.

Adequate fluid intake Humidification of the environment Sucking on hard candy or throat lozenges

Mr. Johnson is prescribed pseudoephedrine to relieve his nasal congestion. What should the nurse include in patient and family education? Select all that apply. Advise him to avoid direct sunlight. Advise him to avoid excessive and frequent use of the drug. Advise him not to take other OTC drugs. Advise him to avoid grapefruit juice. Advise him to avoid eating red meat

Advise him to avoid excessive and frequent use of the drug. Advise him not to take other OTC drugs.

Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug? Conversion of cardiac arrhythmias Treatment of peptic ulcer disease Antidote for acetaminophen poisoning Treatment of bronchospasm

Antidote for acetaminophen poisoning

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. Both drug types loosen bronchial secretions for ease of removal. Antitussives liquefy bronchial secretions while expectorants assist in the expectoration of those secretions. Antitussives kill cold viruses while expectorants liquefy bronchial secretions.

Antitussives suppress coughing while expectorants loosen bronchial secretions.

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 Using household measuring devices for dosage measurements Using adult formulation with smaller doses

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 client is prescribed oxymetazoline. Which assessment data would indicate that the drug is effective? Breathing pattern is regular and without difficulty. Skin is effectively hydrated. Heart rate is maintained at a regular rate and rhythm. Urine output is at least 30 mL/hr.

Breathing pattern is regular and without difficulty.

A client taking metoprolol 50 mg one tablet twice daily begins taking over-the-counter pseudoephedrine. The nurse would assess for which potential reaction? Select all that apply. Bradycardic episode Hyperglycemic episode Hypoglycemic episode Rebound congestion Hypertensive episode

Hypertensive episode Bradycardic episode

A nurse is conducting an ongoing assessment and notes the client is experiencing difficulty bringing up mucus. Which nursing diagnosis should the nurse prioritize for this client? Ineffective Airway Clearance Acute Pain Injury Risk Impaired Oral Mucous Membranes

Ineffective Airway Clearance

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? The medication is not effective for croup. Misuse could result in overdose. The medication is contraindicated for the child's symptoms. The medication is contraindicated for viral infections.

Misuse could result in overdose.

A client is questioning the use of eucalyptus as a decongestant. The nurse should point out that eucalyptus is contraindicated for which clients? Select all that apply. Pregnant females Children younger than 2 years Lactating females Postmenopausal females Men

Pregnant females Children younger than 2 years Lactating females

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? Tetrahydrozoline Xylometazoline Ephedrine Pseudoephedrine

Pseudoephedrine

A male client presents to the health care provider's office with reports of inability to breathe freely. When the nurse reviews his use of over-the-counter medications, it is discovered that the client routinely uses nasal spray three times a day for 1 year. The nurse knows that what may be causing this client's continuous nasal congestion? Chronic nasal polyps Burning of the nares secondary to chronic use of nasal sprays Rebound nasal swelling Damage of the nasal concha

Rebound nasal swelling

A client informs the nurse about taking pseudoephedrine for the relief of nasal congestion due to the common cold. In which situation should the nurse suggest that the client not use this medication since it is a contraindication for this health care concern? The client has a history of cataracts. The client has had a cold for 3 days. The client is being treated for severe hypertension. The client has hypothyroidism.

The client is being treated for severe hypertension.

What statement best describes how the common cold is effected by and managed using medication therapy? Herbal remedies containing zinc have not demonstrated any ability to reduce the symptoms generally associated with a cold. The tendencies to overmedicate and use antibiotics inappropriately with the common cold are widespread and pose significant risk for complications and drug resistance. Colds may be difficult to manage because they often result from drug-resistant microorganisms and occur in people whose immunity is impaired. Because of the way cold viruses are spread, antibiotics are the most important protective and curative measure.

The tendencies to overmedicate and use antibiotics inappropriately with the common cold are widespread and pose significant risk for complications and drug resistance.

The nursing instructor is discussing the use of nasal decongestants and shares what reason for their effectiveness? They are absorbed systemically. They treat multiple symptoms in a cost-effective manner. They come into direct contact with nasal mucosa. Their effects last for 48 to 72 hours.

They come into direct contact with nasal mucosa.

Expectorants elicit their effect by which mechanism? Thinning respiratory secretions Breaking down thick mucus in the lower lungs Depressing the cough center in the brain Anesthetizing stretch receptors in the respiratory passages

Thinning respiratory secretions

Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine? ineffective airway clearance impaired tissue perfusion ineffective breathing pattern risk for infection

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? an inhaled steroid monoamine oxidase inhibitor (MAOI) proton pump inhibitor (PPI) antibiotic

monoamine oxidase inhibitor (MAOI)

The nurse is listening to the respiratory therapist teaching a client about the proper use of respiratory equipment for administration of drugs such as expectorants and mucolytics when they are discharged home. The nurse knows the therapist will inform the client that the best position to do this is which? lying on the back sitting or in high Fowler's position rotating lying on either side there is not a recommended position

sitting or in high Fowler's position