Pharmacology Chapters 32, 33, 41, 42, & 37!
Exercise Allergens Pollutants
A 27-year-old athlete with newly diagnosed asthma presents for patient education regarding situations that could precipitate an asthma attack. The nurse teaches that acute episodes of asthma may last minutes to hours. In this teaching, which precipitants would the nurse state may cause the asthma? (Select all that apply.)
Smoking decreases the size of the tubes leading to the lungs
A 42-year-old male client has a history of smoking for 20 years. The client states he is feeling fine and asks why stopping smoking is necessary. What information might the nurse share with the client about smoking?
Use of nicotine
A 70-year-old client is being treated for chronic obstructive pulmonary disease (COPD) with theophylline. What will be a priority assessment by the nurse?
Hypotension Syncope
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.)
Drowsiness
A 76-year-old client has been prescribed an oral antihistamine. What adverse effect presents a priority safety concern for older adult clients?
Chronic, irreversible dilation of the bronchi and bronchioles
A client arrives in the emergency room with an attack of acute bronchiectasis. What is the principal pathologic finding in the diagnosis of bronchiectasis?
sit in a fully upright position when administering the medication.
A client has been diagnosed with chronic obstructive pulmonary disease. The client has been prescribed bronchodilators by nebulizer for home use. The nurse should teach the client to:
"I don't want lunch; I'm feeling nauseated." "It feels like my heart is beating faster than usual." "The headache I mentioned yesterday still hasn't gone away." "I need to tell you that I vomited a few minutes ago."
A client has been prescribed theophylline intravenously and began the therapy three days ago. The nurse suspects that the serum drug level is above therapeutic levels when the client makes what statement(s)? Select all that apply.
Avoid drinking alcohol while taking antihistamines
A client has begun taking an antihistamine for the treatment of seasonal allergies. What dietary guidelines should the nurse provide to the client?
Beta-2 selective adrenergic agonist
A client is experiencing an acute asthmatic attack. Which agent would be most effective?
"Determine if the drug is going to make you drowsy before you drive."
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?
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?
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?
Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough.
A client reports a hacking cough. The client asks if taking an antihistamine would be helpful. The nurse's best response is:
Decreasing airway hyperreactivity to stimuli
A client with asthma has been prescribed an anti-inflammatory medication. How does an anti-inflammatory drug reduce this client's bronchoconstriction?
Urticaria Vasomotor rhinitis Motion sickness Angioedema
A client's drug regimen includes diphenhydramine. What potential indications may this drug be used for? Select all that apply.
Relaxation of smooth muscle
A client, experiencing respiratory distress related bronchi constriction, will benefit from what therapeutic action provided by anticholinergic medication therapy?
Dry mouth
A female client is prescribed a first-generation antihistamine for her allergies. The nurse would expect her to experience what adverse effect?
Diphenhydramine
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?
Monitoring respirations for bilateral chest movement
A newborn, experiencing ineffective alveolar expansion, is receiving treatment. What intervention should the nurse implement to assure the administration of the prescribed medication has been effective?
Purulent cough
A nurse is caring for a client with chronic bronchiectasis. The nurse should assess the patient for which clinical manifestation?
Allergic rhinitis Parkinsonism Nausea
A nurse is preparing to administer an antihistamine to a client. The nurse integrates knowledge about this class of drugs, identifying which condition or disease as a possible use to alleviate symptoms? Select all that apply.
has a high coffee intake.
A nurse is providing education to a 56-year-old man who is admitted to the emergency department with an acute asthma attack. The nurse's initial assessment reveals that the patient has a history of pneumonia, drinks large quantities of coffee, and eats a high-calorie diet. Albuterol is prescribed for him. The important consideration when the nurse is preparing a teaching plan will be that the patient
I'll keep taking my medications until I'm not experiencing any more symptoms."
A nurse is providing health education to a client recently diagnosed with asthma and prescribed albuterol and ipratropium. Which of the client's statements suggests a need for clarification by the nurse?
"I should avoid driving after taking this medication."
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?
Extremely cold temperatures
A nurse is teaching a client diagnosed with asthma about the disease. Which should the nurse instruct the client to avoid because it may cause bronchoconstriction?
Cigarette smoking
A nurse would expect to increase the dosage of theophylline if the client has a current history of which of the following?
"First-generation antihistamines may cause confusion." "Sedation effects may be misinterpreted as senility or mental depression." "Diphenhydramine is sometimes used as a sleep aid for older adults."
A nursing professor is teaching a class on use of antihistamines in older adults. Which of the following statements made by students indicates an understanding of the lecture? Choose all that apply.
Abdominal cramps
A patient with acute respiratory symptoms is receiving a loading dose of theophylline. Which of the following signs of toxicity should alert the nurse to notify the primary health care provider immediately?
Loratadine
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?
Fluticasone
After teaching a group of students about leukotriene receptor antagonists, the instructor determines a need for additional teaching when the students identify which agent as an example?
"I need to take the medication when I start to have problems breathing."
An adolescent client is prescribed a leukotriene receptor antagonist as a part of a medication regime to manage his/her asthma. Which statement made by the client requires additional education on this classification of medications?
Have the resident rinse his or her mouth after each dose of the drug.
An older adult client has been prescribed an inhaled corticosteroid for the treatment of chronic obstructive pulmonary disease (COPD). Which action should the nurse perform to reduce the client's risk for developing oral candidiasis?
Helping the patient identify environmental allergens
Antihistamines are used frequently in the home care setting for the treatment of allergies. Which of the following is most likely to be a responsibility of the nurse caring for a patient who is taking antihistamines for this indication?
Albuterol
During the summer, a female client experiences increased periods of acute symptoms of her asthma. The health care provider increases the dose frequency of which of her medications?
Hypotension
Intravenous antihistamines are typically administered over a period of a few minutes. What adverse effect can occur if an IV antihistamine is injected rapidly?
Albuterol causes relaxation of the bronchial smooth muscles.
Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?
Obtain the client's blood pressure.
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?
anti-inflammatory agents.
Respiratory symptoms are treated with many types of drugs, including
They do not cross the blood-brain barrier.
Second-generation H1 antagonists cause less CNS depression because they are selective for peripheral H1 receptors and because of which other property?
Fexofenadine
Second-generation antihistamines were developed to remove the sedation of first generation drugs. Which of the following antihistamines is a second-generation drug?
Albuterol first, wait five minutes and then follow with flunisolide
The client has been diagnosed with asthma and is being treated with two inhalers, albuterol and flunisolide. The nurse teaches the client that the two medications should be administered in what order?
Rinse mouth with water after each use.
The client with asthma has been ordered an inhaler and the nurse is teaching how to prevent Candida infections. Which would the nurse include in the instructions?
Coffee
The client's theophylline levels are increased when the lab results are added to the electronic health record. The nurse questions the client about his intake of which?
Nausea and vomiting
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?
"I need to shake the inhaler well before taking the medication."
The nurse has finished teaching a 15-year-old client how to use an inhaler to treat asthma. What statement by the client suggests an understanding of the teaching?
Tachycardia
The nurse is caring for a 38-year-old client who is beginning treatment with albuterol. Which should the nurse identify as a potential adverse effect of the drug?
Lack of patent airway
The nurse is caring for a client with chronic obstructive pulmonary disease. The plan of care will focus on what client problem?
Clear breath sounds
The nurse is monitoring a premature infant diagnosed with respiratory distress syndrome (RDS). Which assessment finding will serve to demonstrate that the instillation of surfactant as a treatment has been effective?
"I should avoid beverages that contain caffeine."
The nurse is providing education to a client who has been prescribed theophylline. The nurse interprets what client statement as a sign of successful teaching?
"I will take this medication with apple juice."
The nurse is providing instructions to a client who will be taking second-generation antihistamines at home. Which statement by the client indicates a need for further instruction?
Contact the care provider and inform him or her that the client has toxic theophylline levels.
The nurse is reviewing a client's morning blood work and notes a theophylline level of 22.2 mcg/mL (123.21 µmol/L). What action should the nurse take?
Read drug labels before taking OTC medications.
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 the labels clearly to make sure you're not giving the same drug in two different preparations."
The nurse is working with parents who are treating their child's cold and flu symptoms at home using over-the-counter (OTC) medications. What guidance should the nurse provide?
Delayed hypersensitivity
The nursing instructor is describing the four types of hypersensitivity reactions. What alternate name might the instructor use to identify type IV hypersensitivity?
type I hypersensitivity reaction.
The nursing instructor is explaining the four types of allergic reaction to the nursing students. The instructor explains that allergic rhinitis is a
"Inhaled steroids will not affect the growth of your child."
The parent of a 4-year-old client taking inhaled corticosteroids, states she has not been routinely administering the medication because of concerned about the child not growing properly. What is the nurse's best response?
Excessive salivation
The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects?
Cough Increased secretions Mucosal congestion
The pulmonologist sees many patients daily who suffer from a variety of respiratory disorders. What are some of the common signs and symptoms many of these patients present? (Select all that apply.)
The client holds his or her breath for several seconds after compressing the canister.
What action by the client would indicate that the client understands how to use an inhaler?
Type I hypersensitivity reaction to Inhaled allergens
What causes the inflammation of nasal mucosa that is seen in allergic rhinitis?
exercise allergens pollutants cigarette smoke
What is considered a possible trigger for an asthma attack? Select all that apply.
They do not impair thinking.
What is one of the benefits related to second generation antihistamine administration in older adults?
gastroesophageal reflux disease (GERD)
What medical condition is likely to be exacerbated by the medication therapy associated with asthma?
diphenhydramine
What medication should be prescribed to minimize the risk associated with a blood transfusion for a client with a history of a previous transfusion reaction?
"If you didn't have allergies as a child, you won't develop allergies later in life."
What statement made by a client suggests a need for further teaching on the risk factors associated with drug allergies?
Stenosing peptic ulcer
When caring for a patient with an allergic reaction following a blood transfusion, which of the following conditions should the nurse consider as a contraindication for antihistamine therapy?
Sedation
When describing the effects of second-generation antihistamines, which would the nurse address as being decreased?
Advising the client to avoid alcohol consumption Using sugarless candies or lozenges to combat dry mouth
When developing the teaching plan for a client receiving an antihistamine, which would the nurse include? (Select all that apply.)
"This drug is likely to make you feel drowsy."
When providing health education to a client prescribed diphenhydramine, what information should the nurse convey to the client?
They act locally to decrease release of inflammatory mediators
Why are inhaled steroids used to treat asthma and COPD?
Benadryl
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?