Chapter 32: Drug Therapy to Decrease Histamine Effects and Allergic Response

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? Antihistamines can be helpful when they're combined with an antibiotic. Yes, but it's important to monitor for adverse effects. Antihistamines are not recommended for treating a cold. Yes, but be sure to use a brand that mentions 'cold remedy' on the packaging.

Antihistamines are not recommended for treating a cold.

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? Desloratadine Cetirizine Diphenhydramine Azelastine

Diphenhydramine may be given by injection, usually as a single dose, to a client who is having a blood transfusion or a diagnostic test, to prevent allergic reactions. Hydroxyzine or promethazine may be given by injection for nausea and vomiting or to provide sedation, but they are not usually the first drugs of choice for these indications.

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

Drowsiness

Question 19 of 20 The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects? Drowsiness Dry mouth Blurred vision Excessive salivation

Excessive salivation

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? Chlorpheniramine Brompheniramine Clemastine Loratadine

Loratadine

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? Joint pain Nausea and vomiting Central nervous system depression Hypotension

Nausea and vomiting

All of the following are drugs less commonly associated with anaphylactic reactions EXCEPT: Vicodin. Tylenol. Tetanus vaccine. Penicillin.

Penicillin.

Combining first-generation antihistamines with sedating agents can result in what adverse effect? Myocardial infarction Hypertensive crisis Liver failure Respiratory depression

Respiratory depression

What type of antihistamine is typically preferred for older adults? First-generation Second-generation Antihistamines are contraindicated in older adults. Neither type is preferred over the other.

Second-generation

When describing the effects of second-generation antihistamines, which would the nurse address as being decreased? Dry mouth Gastrointestinal upset Hypersensitivity Sedation

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. They are metabolized by the liver. They are excreted by the renal system. They cross the blood-brain barrier.

They do not cross the blood-brain barrier.

A client reports nasal congestion, sneezing, watery drainage from the nose, and itching of the throat, eyes, and ears. The nurse recognizes that these are consistent with what disorder? sinus infection anaphylaxis a histamine reaction allergic rhinitis

allergic rhinitis

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. type IV hypersensitivity reaction. type III hypersensitivity reaction.. type II hypersensitivity reaction.

type I hypersensitivity reaction.

A nursing professor is teaching the class regarding the use of antihistamines in patients with renal impairment. Which of the following statements made by students indicates an understanding of the lecture? Choose all that apply. "For some antihistamines, doses for initial use are approximately one half of those used for young and middle-aged adults." "With diphenhydramine, the dosing interval should be extended to 12 to 18 hours." "Renal impairment does not have to be considered, because most antihistamines are metabolized by the liver." "Azelastine may be the drug of choice because it is metabolized in the liver." "Diphenhydramine may be given at regular intervals."

• "With diphenhydramine, the dosing interval should be extended to 12 to 18 hours."• "For some antihistamines, doses for initial use are approximately one half of those used for young and middle-aged adults."• "Azelastine may be the drug of choice because it is metabolized in the liver."

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." "Be sure to take this medication on a full stomach." "You should take the medication twice a day." "This drug has to be taken every 4 to 6 hours."

"Determine if the drug is going to make you drowsy before you drive."

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? "This medication has no serious side effects." "Taking this medication shouldn't stop me from having my after-dinner drink." "It's safe to take this medication with the nighttime sinus medication that I've been using." "I should avoid driving after taking this medication."

"I should avoid driving after taking this medication."

The nurse is providing education to a client regarding the use of an over-the-counter (OTC) antihistamine. Which client statement demonstrates a need for additional teaching? "When I know I'm going to spend time outdoors, I take an antihistamine." "I always need an antihistamine when I visit family members who own pets." "I take the medication to manage my itchy, watery eyes." "When I feel a cold coming on, I know to take an antihistamine."

"When I feel a cold coming on, I know to take an antihistamine."

A client whose daily commute includes travel on a ferry boat has been prescribed diphenhydramine. During client teaching, the nurse should instruct the client to take the medication at what time? when the client boards the ferry the night before each trip as soon as the ferry leaves the dock 30 to 60 minutes before the ferry trip

30 to 60 minutes before the ferry trip

A 15-year-old patient is prescribed an antihistamine for allergic rhinitis. However, antihistamines used to treat allergic reactions may themselves cause allergy. The nurse needs to educate the patient to be aware of symptoms suggesting allergy. Which of the following is an allergic reaction to antihistamines? Skin rash and urticaria Dryness of mouth Disturbed coordination Drowsiness and sedation

Skin rash and urticaria

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 one hour before food. Take an antacid before the tablet. Take the tablet with food. Drink ample water before taking the tablet.

Take the tablet with food.

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 take the morning dose now and the evening dose at the regular time. skip the evening dose and start back in the morning. forget about the morning dose and take the evening dose. double her evening dose.

forget about the morning dose and take the evening dose.Correct Explanation: Since it is only 3 hours until her evening dose, the nurse will instruct her to forget about the morning dose and take the evening dose as scheduled. It is not advisable to take two doses at the same time, and there is no need to skip the evening dose as well. (less)