Pharm. Chap. 39 end questions

A male, age 67, reports taking diphenhydramine (Benadryl) for hay fever. Considering this patient's age, the nurse assesses for which of the following findings?

A history of prostatic or urinary condtions

As the nurse, of the two antitussive medications, dextromethorphan and codeine, which is the drug of choice for this patient? Why?

Although codeine is a more powerful antitussive, it can cause dependence and constipation. Dextromethorphan is a more appropriate choice for this patient initially, with codeine syrup as a potential later choice for more severe cough symptoms.

The nurse is teaching a patient about the use of dextromethorphan with guaifenesin (Robitussin-DM) syrup for a cough accompanied by thick mucus. Which instruction should be included in the patient's teaching?

Avoid drinking fluids immediately after the syrup but increase overall fluid intake throughout the day

George asks why the provider did not give him an antibiotic prescription. What is the best answer to his question?

George has acute viral bronchitis. Antibiotics are used to treat bacterial infections and will not be effective for his viral condition.

What additional measures can George try to relieve his cough and what additional information does he need?

In addition to the antitussive, George should increase his fluid intake throughout the day to help moisten his airway and liquefy any mucus present. Using hard candy or lozenges may prevent the dryness in his throat and decrease coughing. A humidifier at night may also reduce the dryness in his airways. You would also teach George to check his temperature periodically, and if he develops a fever, or if he has increasing sputum production, he should return to the provider to be reassessed.

A 67-year-old patient has allergic rhinitis and always carries a handkerchief in his pocket because he has nasal discharge nearly every day. Sometimes his nose is stuffy and dry. The health care provider prescribes fluticasone (Flonase). He is to take one spray intranasally at bedtime. The patient starts to take fluticasone and a week later calls the provider's office and talks to the nurse. He says, "This Flonase is not helping me." What is the nurse's best response?

Intranasal corticosteroids, such as fluticasone (Flonase), may take as long as 2 to 4 weeks to work. The medication should not be discontinued prematurely. If a decongestant spray is being used along with the Flonase, the decongestant should always be administered first to clear the nasal passages which will facilitate adequate application of the fluticasone.

Which of the following is the best advice that the nurse can give a patient with viral rhinitis who intends to purchase an over-the-counter combination cold remedy?

It is safer to use a single-drug preparation if you are experiencing only one symptom

The patient has been prescribed oxymetazoline (Afrin) nasal spray for seasonal rhinitis. The nurse will provide which of the following instructions?

Limit use of this spray to 5 days or less

A patient has a prescription for fluticasone (Flonase). Place the following instructions in the order in which the nurse will instruct the patient to use the drug. Instill one spray directed high into the nasal cavity. Clear the nose by blowing. Prime the inhaler prior to first use. Spit out any excess liquid that drains into the mouth.

Prime the inhaler prior to first use Clear the nose by blowing Instill one spray directed high into the nasal cavity Spit out any excess liquid that drains into the mouth

A 74-year-old male patient informs the nurse that he is taking diphendydramine (Benadryl) to reduce seasonal allergy symptoms. This patient has a history of BPH and mild glaucoma (controlled by medication). What is the nurse's response?

The nurse should ensure that the patient understands the potential side effects related to the anticholinergic effects of this medication. This patient, based on his age, is at higher risk for urine retention, glaucoma (or other visual changes), and constipation. The nurse should complete a health assessment for these conditions and provide patient education about the need to report any changes to the health care provider.

A patient has been prescribed fluticasone (Flonase) to use with oxymetazoline (Afrin). How should the patient be taught to use these drugs?

Use the oxymetazoline first, then the fluticasone after waiting 5 minutes