Abrams Chapter 31: Drug Therapy for Nasal Congestion and Cough -

The nurse is caring for a client with cystic fibrosis who is receiving dornase alfa by nebulizer to help thin secretions. What statement by the client indicates a need for further instruction?

"I will continue to use postural drainage and take my enzymes as ordered."

The nurse is caring for a client with cystic fibrosis who is receiving dornase alfa by nebulizer to help thin secretions. What statement by the client indicates a need for further instruction?

"I'm glad that this medication will address all of my symptoms."

A nurse is preparing a presentation for a local elementary school parent group about over-the-counter cold medications and their use in children. What information would be most appropriate to include?

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

Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug?

Antidote for acetaminophen poisoning

A client is prescribed oxymetazoline. Which assessment data would indicate that the drug is effective?

Breathing pattern is regular and without difficulty

When providing health education to an adult who is taking an over-the-counter (OTC) combination cold and cough remedy, the nurse should encourage the client to implement what intervention to best assure medication safety?

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

When instructing a patient in how to use a topical nasal spray, what would the nurse emphasize to do first?

Clear the nasal passages.

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?

Drink at least 2 Fl.Oz of water per day

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

Guaifenesin

A client presents at the clinic with a dry, non-productive cough. The client is diagnosed with bronchitis, and it is determined that the client needs help thinning the sputum so the cough can become productive. What does the nurse expect the health care provider will prescribe?

Guaifenesin (Mucinex)

A nurse in a pediatric clinic that treats children with respiratory problems has received orders for 4 patients. What medication order will she question?

Hydrocodone (Hycodan) 10 mg PO for a 5-year-old

A 29-year-old female client has sinusitis, so the health care provider orders a topical nasal decongestant. What instructions should be given?

Increase fluids to 2 L per day

Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine?

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?

Misuse could result in overdose.

A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions?

Mucolytic

Decongestants are available in which dosage forms? (Select all that apply.)

Oral tablets Nasal sprays Nasal drops

Which is classified as a decongestant?

Oxymetazoline (Afrin)

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?

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?

Rebound nasal swelling

Cough syrups serve as vehicles for antitussive drugs and also may exert antitussive effects of their own by doing what?

Soothing irritated pharyngeal mucosa

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?

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 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 is the mechanism of action for decongestants.

The nursing instructor is discussing over-the-counter cold remedies. According to the instructor, these products typically combine

a decongestant, an analgesic, and an antihistamine.

The client states that he/she once needed medication to liquefy secretions in the respiratory tract. However, the client cannot recall the name of the medication but states that the medication is added to a nebulizer. The nurse suspects the client is taking which medication?

acetylcysteine

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?

b) Decongestants

What would be the nurse's best response if a client calls the clinic and reports a persistent cough for 2 weeks and then asks the nurse for a recommendation for a cough medicine?

c) "You should come to the clinic to be evaluated. A cough that lasts that long might be an indication of an underlying medical problem."

The nurse's assessment should prioritize what system when caring for a client who has just been admitted for an overdose of pseudoephedrine?

cardiovascular

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

high Fowler's position.

What is an adverse reaction commonly experienced by people taking nasal decongestants?

rebound congeastion

A 76-year-old man has a history of heart disease, and has been prescribed an oral decongestant. The nurse is concerned with this prescription because of the risk for which?

serious cardiovascular effects.

A 43-year-old man is taking pseudoephedrine (Sudafed) for sinusitis. He calls the clinic to report that it feels like his heart is racing and that he can "feel his heart beating fast." The nurse will instruct him to:

stop taking the medication and come to the clinic as ordered by the physician.

Expectorants elicit their effect by which mechanism?

thinning respiratory secretions

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?

• Swallow capsules whole • Suck on sugarless hard candy • Take frequent sips of water