Chapter 54: Drugs Acting on the Upper Respiratory Tract

A client is receiving dornase alfa at home. Which would the nurse instruct the client to do? "Store the drug at room temperature." "Mix the drug with tap water." "Protect the drug from light." "Take the drug orally with meals."

"Protect the drug from light."

A client reports a hacking cough. The client asks if taking an antihistamine would be helpful. The nurse's best response is: Antihistamines are not used for this issue. Antihistamines are recommended for extended use, as long as you monitor for adverse effects. Antihistamines are not recommended for this issue; only antibiotics are useful. Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough.

Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough.

A client is taking pseudoephedrine. The nurse would assess the client for which adverse effect? Anxiety Lethargy Hypotension Dry skin

Anxiety

A nurse is caring for a patient who has been prescribed a nasal decongestant. Which of the following factors should the nurse assess before administering the drug? Motor coordination Blood pressure Vision Auditory tests

Blood pressure

A female client is diagnosed with type 2 diabetes mellitus, hyperlipidemia, and mild hepatic impairment. She presents to the emergency department after taking promethazine, obtained from a friend, for motion sickness. The nurse would expect what adverse effect? Hypotension Cholecystitis Cholestatic jaundice Abnormal hemoglobin

Cholestatic jaundice

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 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? Xylometazoline Pseudoephedrine Ephedrine Tetrahydrozoline

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

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 Nonselectively binding to central and peripheral H1 receptors Anesthetizing stretch receptors in the respiratory passages

Vasoconstriction of small blood vessels of the nasal membranes

Nasal decongestants would be contraindicated for which client? a client with a pulse rate of 58 beats per minute a client with a history of controlled hypertension a client with a history of coronary artery disease a client with a history of diet-controlled diabetes mellitus

a client with a history of coronary artery disease

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? eucalyptus antihistamine acetaminophen advil

antihistamine

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? antipyretics antimicrobials antianginals antihistamines

antihistamines

An adult client has reported experiencing a dry mouth and urinary retention after several nights of taking an over-the-counter (OTC) sleep aid. The nurse should suspect that this medication contains what antihistamine? loratadine promethazine diphenhydramine olopatadine

diphenhydramine

To help liquefy cold-related secretions, the nurse should encourage the client to implement which measure? reducing salt intake deep breathing and exercises gargling with normal saline increasing fluid intake

increasing fluid intake

The substances released from mast cells are responsible for what physiological response? Select all that apply. myalgia inflammation bronchoconstriction smooth muscle dilation decreased capillary permeability

inflammation bronchoconstriction

Meclizine is used to relieve the nausea and vomiting that occurs with motion sickness. True False

true

A 76-year-old client has been prescribed an oral antihistamine. What adverse effect presents a priority safety concern for older adult clients? Drowsiness Dry mouth Nasal burning Nonproductive cough

Drowsiness

A client is prescribed oxymetazoline, a decongestant, for the treatment of hay fever. What should the nurse evaluate to assess the efficacy of therapy? Maintenance of effective hydration of the skin Maintenance of an effective heart rate Maintenance of effective airway clearance Maintenance of an effective urine output

Maintenance of effective airway clearance

An adult client has asked the nurse to recommend an OTC cold remedy. Before making a recommendation, the nurse should implement which intervention? Consult with a pharmacist or pharmacy technician. Assess the client's understanding of the epidemiology of the common cold and upper respiratory infections. Assess the client for health problems that may contraindicate the use of a particular remedy. Ensure that the client has tried some of the more common herbal and natural remedies.

Assess the client for health problems that may contraindicate the use of a particular remedy.

A patient receives guaifenesin. The nurse would expect the drug to begin acting within which time frame? 30 minutes 15 minutes 45 minutes 60 minutes

30 minutes

A client asks the nurse how long to use oxymetazoline (Afrin) nasal spray for nasal congestion. What is the nurse's best response? "Over-the-counter medications are safe for long-term use." "Consult with your primary care provider." "Afrin can be used as long as nasal burning and stinging do not occur." "Use the medication until your symptoms are completely relieved."

"Consult with your primary care provider."

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 infection related to adverse effects of antihistamines Risk for falls related to sedation Risk for deficient fluid volume related to diuresis Risk for impaired skin integrity related to urticaria

Risk for falls related to sedation

An adult client diagnosed with type 1 diabetes for many years and has begun to experience diabetic nephropathy over the past year. How will this client's current health status influence the possible use of pseudoephedrine in the treatment of cold symptoms? The client should monitor blood glucose levels more frequently when taking pseudoephedrine. The use of pseudoephedrine is absolutely contraindicated by the fact that the client has diabetes and takes insulin. The client may require a higher-than-average dose of pseudoephedrine because of excess fluid volume secondary to renal failure. The client should use caution and will likely require a lower dose of pseudoephedrine because of impaired renal function.

The client should use caution and will likely require a lower dose of pseudoephedrine because of impaired renal function.

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 will blow my nose before using the nasal spray." "I will rinse the spray tip off after each use." "I can take over-the-counter pseudoephedrine, too." "The drug is used no longer than 3 days."

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

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

Antidote for acetaminophen poisoning

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

Importance of reading the label for ingredients and dosage Avoidance of use in children under age 2 Need to follow the directions for how often to give the drug

An older client diagnosed with hypertension is requesting an oral nasal decongestant for cold symptoms. Which statement by the nurse best describes the effect of decongestants on blood pressure? "The administration of a nasal decongestant will increase blood pressure due to vasoconstriction of blood vessels." "The administration of a nasal decongestant will cause bradycardia and increase peripheral blood pressuregastric reflux." "The administration of a nasal decongestant will decrease the thyroid production and increase rebound congestion." "The administration of nasal decongestant will act on the central nervous system to cause vasodilation of blood vessels."

"The administration of a nasal decongestant will increase blood pressure due to vasoconstriction of blood vessels."

What information should the nurse provide a mother of a 3-year-old concerning the safety and efficacy of over-the-counter (OTC) cough and cold products containing pseudoephedrine for young children? Cough and cold remedies are generally safe and effective for children over the age of 2. There are concerns among health professionals about how safe and effective these medications are. Media reports about the risks of cough and cold medications in children have greatly exaggerated the fear of risks. Risk can be minimized by using age-specific preparations of cough and cold remedies.

There are concerns among health professionals about how safe and effective these medications are.

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. Benzonatate capsules should be sucked on like a lozenge. Consumption of alcohol is okay while taking benzonatate. Benzonatate can be taken more frequently than prescribed if needed

Benzonatate can cause GI upset and sedation. The client should drink plenty fluids.

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? He is healthier because he uses the echinacea. Echinacea is the OTC drug of choice for prevention of viral infections. To be effective, echinacea must be taken daily regardless of symptoms. There is limited or no support for the use of echinacea to prevent or treat symptoms of the common cold.

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