pharmacology ch 30

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."

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 recommended because they can dry lower respiratory secretions and worsen secretion retention and cough.

Which of the following are included in the pre-administration assessment of an antihistamine? Select all that apply:

Asking about symptoms Asking about prescription medications

A client has been prescribed an antihistamine for the treatment of seasonal allergies. What dietary guidelines should the nurse provide to the client?

Avoid drinking alcohol while taking antihistamines

A male client presents to the emergency department with symptoms of a gastrointestinal bleed. The health care provider orders a blood transfusion. The client has a history of anaphylaxis. The provider orders the administration of what drug before the blood transfusion?

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

A female client is prescribed a first-generation antihistamine for her allergies. The nurse would expect her to experience what adverse effect?

Dry mouth

A 74-year-old male client is diagnosed with hypertension, hyperlipidemia, angina, and gout. He presents to the health care provider's office with reports of seasonal allergies. His daughter has diphenhydramine at home, and he asks if it is safe for him to take it. The nurse is concerned because first-generation antihistamines may cause what adverse effects in older adults? (Select all that apply.)

Hypotension Syncope

The term antihistamine generally indicates classic or traditional drugs. These drugs prevent or reduce most of the physiologic effects that histamine normally induces at H1 receptor sites. Which of the following are direct results of H1 antagonists? Choose all that apply

Inhibit smooth muscle constriction in blood vessels and the respiratory and GI tracts Decrease capillary permeability Decrease salivation and tear formation

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

A patient presents at the emergency department with symptoms that lead the triage nurse to suspect serum sickness. What is one of the symptoms the nurse may have observed?

Myalgia

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

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.

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.

A client's report of nasal congestion, itching, sneezing, and watery drainage, including itching of the throat, eyes, and ears are consistent with what situation?

allergic rhinitis

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, having an allergic reaction to mold, describes chest tightness and difficulty breathing. Which body effect is occurring?

contraction of the 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

Promethazine (phenergan) is the only antihistamine formulated as a nasal spray for topical use. True or false.

false

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

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

histamine

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

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

Patients with drug allergies should wear a medical alert bracelet identifying the drug. True or false?

true

What type of hypersensitivity reaction causes allergic rhinitis?

type I

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

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."

Your client has a history of post-transfusion reactions. Her medical provider has ordered medication to prevent this. Which of the following medications would you anticipate being ordered for this client?

Benadryl

The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects?

Excessive salivation

Second-generation antihistamines were developed to remove the sedation of first generation drugs. Which of the following antihistamines is a second-generation drug?

Fexofenadine

Hypersensitivity reactions are grouped into four types according to the mechanisms by which they are produced. Type I hypersensitivity reaction for allergic rhinitis follows a specific pattern. Please place the following in order as they would occur.

First exposure to inhaled antigens Formation of immunoglobulin E (IgE) antibody molecules IgE binds to and sensitizes the surface membranes of mast cells Re-exposure to inhaled pollens or other antigens Release of histamine and other chemical mediators Nasal mucosa produces characteristic symptoms of allergic rhinitis

Mr. Zee is prescribed an inhaled nasal steroid to relieve his symptoms associated with seasonal allergies. What is true about inhaled nasal steroids?

Inhaled nasal steroids are more effective than oral medications in treating the global symptoms associated with allergies.

What type of antihistamine is typically preferred for older adults?

Second-generation

A 41-year-old patient with an allergy to tree pollen and grasses plans to mow the lawn. When is the best time for the patient to self-administer fexofenadine?

Three hours before mowing the lawn

What causes the inflammation of nasal mucosa that is seen in allergic rhinitis?

Type I hypersensitivity reaction to Inhaled allergens