PHARM CH 54 PREPU
A client has expressed frustration stating, "I've been taking an over-the-counter (OTC) decongestant for several days and it still hasn't really cured my cold." What teaching point should the nurse convey to the client? a. "Drugs like this can often relieve some of the symptoms of a cold, but they won't cure it." b. "Most people find that cold medications are essentially ineffective." c. "It usually takes between 8 and 10 days for a decongestant to cure affect cold symptoms." d. "Sometimes a decongestant can sometimes mask the effects of your cold, essentially prolonging it."
a. "Drugs like this can often relieve some of the symptoms of a cold, but they won't cure it." Most people experience some relief, but clients should be made aware that cold medications do not cure the common cold; they only relieve some symptoms. Over-the-counter (OTC) cold remedies should not be used longer than 1 week. Such medications do not inhibit healing by masking symptoms.
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? a. Antihistamines are not recommended for treating a cold. b. Yes, but it's important to monitor for adverse effects. c. Yes, but be sure to use a brand that mentions 'cold remedy' on the packaging. d. Antihistamines can be helpful when they're combined with an antibiotic.
a. Antihistamines are not recommended for treating a cold. Although antihistamines are popular over-the-counter drugs, studies have demonstrated that they are not successful or recommended for the treatment of the common cold. An antibiotic should not be prescribed for the treatment of the common cold, which is a viral disorder.
A patient with allergic rhinitis is prescribed an antihistamine. The nurse instructs the patient to suck on a sugarless hard candy to prevent which condition? a. Dryness of the oral mucosa and the throat b. Thickening of the bronchial secretion c. Drowsiness and sedation d. Altered sensation of taste
a. Dryness of the oral mucosa and the throat The nurse should instruct the patient to suck on a sugarless hard candy to prevent dryness of the oral mucosa and the throat seen as a side effect of antihistamine therapy.
When developing the teaching plan for a client receiving an antihistamine, which would the nurse include? (Select all that apply.) a. Using sugarless candies or lozenges to combat dry mouth b. Advising the client to avoid alcohol consumption c. Encouraging the client to engage in usual activities such as driving d. Stopping the drug after 3 days if no relief is obtained
a. Using sugarless candies or lozenges to combat dry mouth b. Advising the client to avoid alcohol consumption When taking an antihistamine, the nurse needs to inform the client to take the drug on an empty stomach, 1 hour before or 2 hours after meals, use sugarless candies to combat dry mouth, to read the labels of OTC medications because they may contain the same ingredient or alcohol, which could increase the risk of adverse effects or toxicity, and to avoid alcohol intake to prevent excess CNS effects.
A client is experiencing allergy symptoms after being exposed to environmental dust. This reaction involves the action of histamine, which is released by what cells? a. CD4 T cells b. Basophils c. Lymphocytes d. Platelets
b. Basophils Histamine is discharged from mast cells and basophils in response to certain stimuli, such as allergic reactions, cellular injury, and extreme cold. Lymphocytes and platelets do not release histamine. CD4 cells (often called T cells or T-helper cells) are a type of white blood cells that play a major role in protecting the body from infection.
When instructing a client in how to use a topical nasal spray, what would the nurse emphasize to do first? a. Lie down to tilt the head back. b. Clear the nasal passages. c. Close the opposite nares. d. Spray the medication with the bottle upright.
b. Clear the nasal passages. Before administering the nasal spray, it would be important to clear the nasal passages to ensure that the medication reaches its intended target thereby promoting effectiveness.
A client calls the clinic and reports symptoms of a cold. The client is most concerned because the cold symptoms are preventing him from sleeping. The nurse would inform the client that what medication relieves cold symptoms and aids sleep? a. Antihistamine b. Diphenhydramine c. Epinephrine d. Phenergan
b. Diphenhydramine Antihistamines are clearly useful in allergic conditions, but their use to relieve cold symptoms is controversial. First-generation antihistamines (e.g., chlorpheniramine, diphenhydramine) have anticholinergic effects that may reduce sneezing, rhinorrhea, and cough. Also, their sedative effects may aid sleep. Many multi-ingredient cold remedies contain an antihistamine.
A nurse is describing the action of a prescribed antihistamine to a client. The nurse is describing which medication, by explaining that the drug elicits its antihistamine effects by non-selectively binding to central and peripheral H1 receptors? a. Loratadine b. Diphenhydramine c. Cetirizine d. Fexofenadine
b. Diphenhydramine Diphenhydramine is a first-generation antihistamine. First-generation antihistamines elicit their antihistamine effects by non-selectively binding to central and peripheral H1 receptors. Second-generation antihistamines, such as cetirizine, fexofenadine, and loratadine, elicit their effects by being selective for peripheral H1 receptors only.
The nurse is teaching a community group about prevention measures to protect against the common cold. Which preventive measure is most important to teach? a. Maintaining vaccinations b. Frequent handwashing c. Taking 1200 g of vitamin C d. Taking Echinacea daily
b. Frequent handwashing Because of the way cold viruses are spread, frequent and thorough hand hygiene is the most important protective and preventive measure.
The nurse is planning care for a client who is experiencing excessive respiratory tract secretions. What intervention should the nurse include? a. administration of guaifenesin b. deep breathing and coughing exercises c. supplemental oxygen d. administration of pseudoephedrine
b. deep breathing and coughing exercises With excessive respiratory tract secretions, mechanical measures (e.g., coughing, deep breathing, ambulation, chest physiotherapy, forcing fluids) are more likely to be effective than expectorant drug therapy.
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? a. "It's best to take small doses of decongestants several times daily rather than two larger doses each day." b. "You can probably expect to get relief within the next few days or a week at the longest." c. "You might find yourself more congested than ever as your body compensates for your use of these drugs." d. "Over-the-counter decongestants don't normally work; you'll likely need to get a prescription for something more effective."
c. "You might find yourself more congested than ever as your body compensates for your use of these drugs." Frequent, long-term, or excessive use of decongestants induces rebound congestion. Rebound congestion occurs when the nasal passages become congested as the drug effect wears off and the body compensates by vasodilating the same nasal arterioles that the drug constricted. This does not occur because of the ineffectiveness of decongestants, however. Dosing should be based on the instructions provided.
Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug? a. Conversion of cardiac arrhythmias b. Treatment of peptic ulcer disease c. Antidote for acetaminophen poisoning d. Treatment of bronchospasm
c. Antidote for acetaminophen poisoning Oral acetylcysteine is widely used in the treatment of acetaminophen overdosage.
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? a. Joint pain b. Central nervous system depression c. Nausea and vomiting d. Hypotension
c. Nausea and vomiting Promethazine is most commonly used in the treatment of nausea and vomiting.
A client reports anxiety, restlessness, nausea, and vomiting after using a nasal decongestant. Which drug should the nurse consider as the cause for these side effects? a. Phenylephrine b. Ephedrine c. Pseudoephedrine d. Epinephrine
c. Pseudoephedrine The side effects of pseudoephedrine include anxiety, restlessness, nausea and vomiting. The drugs ephedrine, epinephrine, and phenylephrine do not cause these side effects. Their side effects include nasal burning, stinging, dryness, and a rebound nasal congestion.
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.) a. Consumption of alcohol is okay while taking benzonatate. b. Benzonatate capsules should be sucked on like a lozenge. c. The client should drink plenty fluids. d. Benzonatate can be taken more frequently than prescribed if needed. e. Benzonatate can cause GI upset and sedation.
c. The client should drink plenty fluids. e. Benzonatate can cause GI upset and sedation. The adverse effects of benzonatate include sedation, headache, dizziness, constipation, nausea, GI upset, pruritus, and nasal congestion. It is recommended that patients with cough drink plenty of fluids (1500 to 2000 mL daily) unless fluids are contraindicate due to another disease state. Benzonatate should not be crushed or chewed due to a local anesthetic effect resulting in possible choking. Consumption of alcohol while taking benzonatate can increase CNS depression and increased sedation. The maximum daily dose of benzonatate is 600 mg daily.
Which agent would a nurse expect the health care provider to prescribe for a client experiencing motion sickness? a. Clemastine b. Hydroxyzine c. Cyproheptadine d. Meclizine
d. Meclizine Meclizine is used to relieve the nausea and vomiting associated with motion sickness. Clemastine, cyproheptadine, and hydroxyzine are used to provide relief of seasonal and perennial allergic rhinitis.
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? a. The medication is contraindicated for viral infections. b. The medication is not effective for croup. c. The medication is contraindicated for the child's symptoms. d. Misuse could result in overdose.
d. Misuse could result in overdose. Several OTC cough and cold medicines for use in infants have been recalled voluntarily due to concerns about possible misuse that could result in overdoses.
A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions? a. Centrally acting antitussive b. Peripherally acting antitussive c. Antihistamine d. Mucolytic e. Expectorant
d. Mucolytic Mucolytic drugs may be used by patients suffering from conditions such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, pneumonia, or tuberculosis to reduce the viscosity of respiratory secretions by direct action on the mucus. Mucolytic drugs increase or liquefy respiratory secretions to aid the clearing of the airways in high-risk respiratory patients who are coughing up thick, tenacious secretions.
Which is classified as a decongestant? a. Levocetirizine (Xyzal) b. Azelastine (Astelin) c. Dextromethorphan (Delsym) d. Oxymetazoline (Afrin)
d. Oxymetazoline (Afrin) Afrin is a decongestant. Xyzal is a second-generation antihistamine. Delsym is a centrally acting antitussive that contains dextromethorphan. Astelin is a second-generation antihistamine.
A male client is diagnosed with chronic bronchitis. What would the nurse expect to be one of his physical reports? a. Rhinorrhea b. Chronic nasal swelling c. Rhinitis d. Retention of secretions
d. Retention of secretions Retention of secretions commonly occurs with influenza, pneumonia, upper respiratory infections, acute and chronic bronchitis, emphysema, and acute attacks of asthma.
