Chapter 32: Drug Therapy to Decrease Histamine Effects and Allergic Response
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 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."
The nurse is teaching a client about the potential for allergic drug reaction. What statement made by a client suggests a need for further teaching?
"If you didn't have allergies as a child, you won't develop allergies later in life."
The nurse is providing education to a client regarding the use of an over-the-counter (OTC) antihistamine. Which client statement demonstrates a need for additional teaching?
"When I feel a cold coming on, I know to take an antihistamine."
A client whose daily commute includes travel on a ferry boat has been prescribed diphenhydramine. During client teaching, the nurse should instruct the client to take the medication at what time?
30 to 60 minutes before the ferry trip
Which client is most likely to benefit from the administration of a nasal steroid?
A client who has chronic allergic rhinitis
Which systemic response of anaphylaxis may be successfully treated with antihistamine therapy?
Anaphylaxis is a systemic reaction that usually involves the respiratory, cardiovascular, and dermatologic systems. Antihistamines are helpful in treating rhinitis-related discharge, urticaria (hives), and pruritus (itchy rash) but are not effective in treating bronchoconstriction (feeling of chest tightness) and hypotension.
A client exhibiting signs and symptoms of the common cold asks the nurse if taking an antihistamine would be helpful. What is the nurse's best response?
Antihistamines are not recommended for treating a cold.
When considering possible side effects, which client should be considered for a prescription of cetirizine rather than diphenhydramine?
Any adult older than 56-years-of age.
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-
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 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
What conditions would be indications for a prescription of a first-generation antihistamine? Select all that apply.
Indications for a first-generation antihistamine like diphenhydramine include hypersensitivity reactions (allergic rhinitis, conjunctivitis, dermatitis), motion sickness, insomnia, and parkinsonism. Neither emphysema nor pneumonia would be positively managed by diphenhydramine therapy
A client has an important presentation to make in 4 hours, and he needs relief from the congestion of seasonal rhinitis. The client calls the nurse, explains the situation, and tells the nurse that he cannot afford to be drowsy. What medication is most likely to meet this client's needs?
Loratadine
A patient with vasomotor rhinitis has been prescribed an antihistamine. The patient is eager to know whether the prescribed antihistamine may cause excessive sedation. Which of the following antihistamines has very little sedative effect?
Loratadine
The health care provider has ordered promethazine (Phenergan) for a client who is having a severe allergic reaction. The nurse is aware that this medication is also used to treat what condition?
Nausea and vomiting
All of the following are consistent with a drug reaction EXCEPT:
Occurs after a loading dose.-All of the following are true of drug reactions: follow ingestion of a drug, especially one known to produce allergic reactions; occur approximately 7 to 10 days after initial exposure to the suspected drug (to allow antibody production); follow a previous exposure to the same or similar drug (sensitizing exposure); occur minutes or hours after a second or subsequent exposure; and occur after small doses (reduces the likelihood that the reaction is due to dose-related drug toxicity).
Combining first-generation antihistamines with sedating agents can result in what adverse effect?
Respiratory depression-First-generation antihistamines have sedating properties. Combining them with other sedating agents, such as alcohol, can cause additive CNS depression, leading to lethargy, stupor, respiratory depression, coma, and death.
What type of antihistamine is typically preferred for older adults?
Second-generation
What type of antihistamine is typically preferred for older adults?
Second-generation antihistamines are typically preferred for older adults because they lack some of the adverse effects associated with the first-generation versions.
When describing the effects of second-generation antihistamines, which would the nurse address as being decreased?
Sedation
A 15-year-old patient is prescribed an antihistamine for allergic rhinitis. However, antihistamines used to treat allergic reactions may themselves cause allergy. The nurse needs to educate the patient to be aware of symptoms suggesting allergy. Which of the following is an allergic reaction to antihistamines?
Skin rash and urticaria
Which food allergens have a higher inherent risk for triggering anaphylaxis?
Some food allergens such as shellfish, egg, milk, peanut, and tree nuts have a higher inherent risk for triggering anaphylaxis than others.
A 62-year-old client has been prescribed an antihistamine to alleviate vasomotor rhinitis. The client reports gastric irritation after taking the tablet. Which instructions should the nurse provide to help alleviate the client's condition?
Take the tablet with food.
A 62-year-old client has been prescribed an antihistamine to alleviate vasomotor rhinitis. The client reports gastric irritation after taking the tablet. Which instructions should the nurse provide to help alleviate the client's condition?
Take the tablet with food.-If the client has gastric irritation following ingestion of the antihistamine, the nurse should instruct the client to take the tablet with food and not before food. Taking an antacid before the tablet may reduce the absorption of the antihistamine. Drinking ample water before taking the tablet will not help to alleviate the patient's condition.
Second-generation H1 antagonists cause less CNS depression because they are selective for peripheral H1 receptors and because of which other property?
They do not cross the blood-brain barrier.
The nursing instructor is explaining the four types of allergic reaction to the nursing students. The instructor explains that allergic rhinitis is a
Type I hypersensitivity reaction to Inhaled allergens
What causes the inflammation of nasal mucosa that is seen in allergic rhinitis?
Type I hypersensitivity reaction to Inhaled allergens
A client reports nasal congestion, sneezing, watery drainage from the nose, and itching of the throat, eyes, and ears. The nurse recognizes that these are consistent with what disorder?
allergic rhinitis
A 20-year-old woman calls the clinic at 5 PM and reports to the nurse that she forgot to take her morning dose of fexofenadine (Allegra). She usually takes her evening dose at 8 PM. She wants to know what she should do. The nurse will instruct her to
forget about the morning dose and take the evening dose.
The nurse regularly assesses clients for risk of anaphylactic reaction to prescribed medications. The nurse is aware that such reactions most commonly occur with what type of medication?
penicillins
The nursing instructor is explaining the four types of allergic reaction to the nursing students. The instructor explains that allergic rhinitis is a
type I hypersensitivity reaction.
