Chap 54 PrepU

A nurse is teaching a 55-year-old patient about fexofenadine after the physician prescribed the medication to treat allergic symptoms. Which patient statement suggests that the patient understands this teaching?

"I should avoid driving after taking this medication."

What are some advantages of using a second-generation antihistamine over a first-generation antihistamine? (Select all that apply.)

-Less sedation -Fewer anticholinergic effects

Codeine containing antitussives should be used cautiously in clients with which conditions? (Select all that apply.)

-Pregnancy -Convulsive disorders -Prostatic hypertrophy

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.

What adverse effect of most oral antihistamines 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

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

Excessive salivation

Which drug is classified as an expectorant?

Guaifenesin (Robitussin)

A patient is using oxymetazoline (Afrin). Which condition will contraindicate the use of this adrenergic drug?

Hypertension

Which agent would a nurse expect the health care provider to prescribe for a client experiencing motion sickness?

Meclizine

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 physician advises against the medication for what reason?

Misuse could result in overdose.

A male client states that he is taking medication to liquefy secretions in his respiratory tract. However, he cannot recall the name of the medication. He states that the medication is added to a nebulizer. The nurse suspects he is taking:

Mucomyst

The physician 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 patient is prescribed an antitussive agent with codeine and receives patient education. Which statement by the patient indicates that the teaching has been effective?

"This medication will cause drowsiness, and I will not drive."

The nurse would caution clients with which disorders to avoid the use of over-the-counter pseudoephedrine? (Select all that apply.)

-Cardiovascular disorders -Glaucoma -Diabetes

The use of centrally acting antitussives, such as codeine, increase the risk for injury related to which conditions? (Select all that apply.)

-Drowsiness -Dizziness

A patient, aged 82 years, is prescribed an antihistamine for the relief of allergic rhinitis. An older age predisposes the patient to a higher risk of adverse effects. Which adverse effects is a nurse more likely to observe in the patient? (Select all that apply.)

-Sedation -Dryness of throat -Confusion

Mucolytics are often used for patients with cystic fibrosis, COPD, or tuberculosis.

True

A client asks the nurse how long he should use oxymetazoline (Afrin) nasal spray for nasal congestion. What is the nurse's best response?

"Consult with your primary care provider."

A patient receives guaifenesin. The nurse would expect the drug to begin acting within which time frame?

30 minutes

A patient is admitted to the emergency room after consuming 50 acetaminophen tablets in a suicide attempt. What medication will be administered to counteract the effect of the acetaminophen?

Acetylcysteine (Mucomyst)

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

Antidote for acetaminophen poisoning

A 45-year-old female client is being seen in the physician's office for a dry, hacking cough that is keeping her up at night. The physician prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan?

Dextromethorphan works in the medulla to suppress the cough reflex.

Second generation antihistamines are associated with a higher risk of sedation than first generation antihistamines.

False

A female patient presents at the clinic with a dry, nonproductive cough. The patient is diagnosed with bronchitis, and it is determined that she will need help thinning sputum so that the cough can become productive. What does the nurse expect the physician will prescribe?

Guaifenesin

A group of students are reviewing information about antihistamines. The students demonstrate understanding of the information when they identify which agent as a second generation antihistamine?

Loratadine

A patient 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 airway clearance

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

Mucolytic

Which is classified as a decongestant?

Oxymetazoline (Afrin)

A male client is diagnosed with chronic bronchitis. What would the nurse expect to be one of his physical reports?

Retention of secretions

When describing the effects of second-generation antihistamines, which would the nurse address as being decreased?

Sedation

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.

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

True

Decongestants elicit their effect by which mechanisms?

Vasoconstriction of small blood vessels of the nasal membranes

Ms. James contacts her physician's office and asks if it is safe to use diphenhydramine while breast-feeding. The nurse's answer is based on the fact that diphenhydramine is a pregnancy category B drug and on which characteristic?

it may inhibit lactation

After teaching a client who is receiving an antitussive about the drug, which statement indicates the need for additional teaching?

"I'll keep the room warm and toasty."

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.)

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

When antihistamines result in dryness of the mouth, the nurse should recommend which actions to relieve the dryness? Select all that apply.

-Take frequent sips of water. -Offer ice chips. -Suck on sugarless hard candy.

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 patient about this prescription during discharge counseling? (Select all that apply.)

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

Which of the following would a nurse identify as a first generation antihistamine? Select all that apply.

-clemastine -dimenhydrinate

What elicits its antihistamine effects by nonselectively binding to central and peripheral H1 receptors?

Diphenhydramine

Pseudoephedrine (Sudafed) is prescribed for a client suffering from nasal and sinus congestion. What is the most important assessment the nurse should complete before the client leaves the clinic to purchase the medication?

Obtain the client's blood pressure.

Which agent would the nurse instruct a client to use orally?

Pseudoephedrine

A male client presents to the physician'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

The nursing instructor is discussing the use of nasal decongestants and shares what reason for their effectiveness?

They come into direct contact with nasal mucosa.