Pharmacology chapters 32-34
the following statement indicates that the patient understands that purpose of the peak flow meter
" i should measure my peak flow medication everyday"
difference between the 1st and 2an generation histamine
- 1st generation bind non-selectivity to central and peripheral H1 receptors and many result in CNS stimulation or depression -2nd generation are selective for peripheral H1 receptors and as a group are less sedating
Mucolytic Used
-acute broncho-pulmonary -tracheotomy care -pulmonary complications of cystic fibrosis -atelectasis -acetaminophen
What is anti-cholingric action?
-affect the respiratory system -dryness of the mouth, nose, and throat -thickening of bronchial secretions
Antihistamines can be used to treat which of the following conditions?
-allergic rhinitis -treatment of parkinsonism -relief of nausea
what are the interventions of comfort measure for patient with viral condition
-antihistamines to relieve allergy symptoms -decongestants to reduce nasal edema antitussives, mucolytic, and expectorants to treat accompanying cough
patient with a cough visits a health care facility and is prescribed an expectorant. What pre-administration assessment should the nurse perform for this patient
-assess the respiratory status of the patient -document the lung sounds of patient -document the consistency of sputum
COPD Disorders
-asthma -chronic bronchitis -chronic obstructive bronchitis -emphysema -combination of the following conditions
what are common lower respiratory disorders?
-asthma -emphysema -chronic bronchitis -COPD
A nurse at a health care center is assigned to prepare to teaching plan for a patient undergoing antitussive drug therapy. Which of the following instructions should the nurse include in the teaching plan:
-avoid irriants such as cigarette dust, or fumes -avoid drinking fluids for 30 minutes after taking the drug -take medicine with milk too enhance absorption
which of the following instructions should the nurse provide a patient who is prescribed an antihistamine for hay fever?
-avoid the use of alcohol and other sedatives -take the drug with food to avoid gastric upset -take frequent sips of water or suck on hard candy
What drugs are used to treat lower respiratory disorders?
-broncho-dilating drugs -B2 adrengic agonist -Xanrhine derivates -Antiasthma Drug -Corticosteriods -Leukotriene modifiers -mast cell blast stabilizers
A patient has been prescribed a mutli-drug regimen for the treatment of asthma. Which of the following drugs may be given as adjuncts to bronchodilator therapy in such a case?
-corticosteroids -leukotriene formation inhibitors mast cell stabilizers
Asthma exacerbation are usually preceded by an increase in which of the following symptoms?
-cough -chest tightness -dyspnea
A nurse has been complaining of nausea after receiving asthmatic medication. Which of the following instructions should the nurse provide to alleviate the patient's condition?
-eat frequent small meals -limit fluids with meals -rinse mouth properly after food
what are the possible risk for treat a elderly patient who over dosage on decongestant medication
-hallucination -convulsion -depression
a patient is prescribed a decongestant for allergic rhinitis. In which of the following conditions should the nurse administer the drug cautiously?
-hypertension -hyperthyroidism -glaucoma
what are common upper respiratory disorders?
-infections -allergic rhinitis -coughs -the common cough -congestion
side effects of antitussive
-light headiness -dizziness -drowsiness or sedation -stomach CONSTIPATION
Mucolytic or Expectorant pre assessment
-nurse documents lung sounds -amount of dyspnea -consistency of sputum -description of sputum for baseline comparison
what triggers attacks?
-pet dander -mold -cockroach waste -physical exercise
Given are random order are the steps involved in the progress of chronic inflammation seen in asthma. Arrange the steps in order.
-release of histamine from the mast cells -increased mucus production and edema of the airway -broncho-spasm and inflammation -narrowing and clogging of the airways -Decreased airflow to the lungs
A patient has be prescribed an antihistamine for urticaria. he wants to know about the possible side effects of the drug. Which of the following are the possible side effects with this medication?
-thickening of bronchial secretions -disturbed coordination -anaphylactic shock or urticaria
what are three types of histamines
1) H1- contract smooth muscle and dilate capillaries 2) H2- heart rate and gastric secretions increase when activated 3) receptor located throughout the nervous system
Theophylline Therapeutic level
10 to 20 mcg/mL likely to occur in patient who require high dose or during prolonged therapy
Which of these drugs would mostly likely be used in caring for a patient with a tracheotomy ?
Acetylcysteine
A patient has been prescribed a nasal decongestant to relieve symptoms of nasal congestion. The nurse needs to educate the patient about how to administer the drug. Which of the following procedures should be followed?
Administer the inhaler by warming it in hand before use
Which of the following is an example of a short-acting beta 2 agoonist (SABA)?
Albuterol
The mucolytic acetylcysteine is used to treat _____ due to mucus obstruction.
Atelectasis
a patient is prescribed aminophylline for the symptomatic relief of bronchial asthma. The nurse is required to inform the patient about other drugs that may interact with aminophylline. Which of the following drugs increase the effects of aminophylline?
Beta-blockers
which of the following elicits its antihistamine effects by selectively binding to peripheral H1 receptors?
Desloratadine
When ____ is administered with MAOI's inhibitors, patients may experience jerking motions in the leg.
Dextromethorphan
what antihistamines are administered to patient, receiving CNS depressants, the nurse monitors the patient for ____
Excessive Sedation
Older adults are at increased risk for experiencing the decongestants over dosage of the decongestants may cause_____.
Hallucinations
______is produced from amino acid histidine.
Histamine
A nurse is caring for a patient who has been prescribed a medication containing potassium. The patient inform the nurse that he is taking a drug containing iodine product. which possible effect of the interaction of potassium containing medication with iodine products should the nurse be aware?
Hypokalemia
A patient is admitted into a healthcare facility with complaints of cough, difficulty breathing, and wheezing sounds during respiration's. The patient is diagnosed as having asthma Which will the nurse observe in the patient.
Increased sweating
Expectorants Interaction
Iodine products, Lithuim, anti thyroid drugs potentiate the hypothyroid effects of these drugs patients could experience Hypokalema, cardiac arrhythmias cardiac arrest thyroid function test
Potassium Iodide adverse reaction
Iodine sensitivity or iodinism sore mouth, metallic taste, increased salivation, nausea, vomiting, epigastric pain, parotid swelling and pain
Cholinergic Blocking Drugs
Ipratropium - Atrovent Tiotropiugm - Spiriva
a client is taking levothyroxine 150 mcg daily for hypothyroidism. which of the following medications should be avoided is this client?
Potassium Iodide
which of the following is a common adverse reaction seen when administering an antihistamine?
Sedation
wehich of the following laboratory tests would the nurse expect to be ordered for a patient taking Theo-Dur?
Serum theophylline
A client was u sing a nicotine patch to stop smoking when he was stated in theophylline for emphysema. He has successfully stop smoking and has stopped using his Nicotine patch. Which of the following would be warranted?
Theophylline dose should be decreased
what is a cough
a cough is a forceful expulsion of air from the lungs
productive cough
a cough that has sputum
the nurse is to administer a mucolytic agent, which of the following nursing action is appropriate to take to promote and effective airway?
a) increase fluid intake to 2000mL per day
Terbutaline is a broncho-dilator with B2 receptor ______ activity.
agonist
short acting - quick relief medications
albuterol - proventil, Ventolin epinephrine bitolterol - tornalate
Xanthines
also called (methylxanthines) are different classes of drugs from adrenegric also have broncho-dilating activity theopylline aminophylline
Xanthine Drugs
aminophylline -truphylline (rectal suppository) dyhylline - Lufyllin oxtriphylline - Choledy SA Theophylline - theo- dur
how does antitussive act peripherally
anesthetizing stretch receptors in the respiratory passages thereby decreasing coughing
antihistamines need to be used cautiously in certain conditions should the nurse administer the drug with caution?
angle-closure glaucoma
upper respiratory infections are treated with what
antibiotics if bacteria are involved
Why are the antihistamines administered intramuscularly instead of subcutaneously?
antihistamines irritate subcutaneous tissue
Leukotrienes
are one of the several substances that are released by mast cells during an asthma attack. leukotrienes are primary responsible for broncho constriction
ICSs
are the most consistently effective long-term control medication at all steps of care for persistent asthma.
long-care asthma medications
arformoterol - brovana formoterol - foradil salmetrol - serevent diskus
what is the mechanism of asthma
asthma has periods of exacerbation alternating with periods of normal lung functions
Promethazine is prescribed to a patient who is also receiving an opioid analgesic. Which of the following factors should the nurse assess in the patient before administering Promethazine ?
blood pressure
Action of Mucolytic
breaks down thick,tenacious mucus in the lower portions of the lungs
In random order these are the steps of inflammatory response to injury. Arrange the inflammatory response in the order they most likely occur in most situations.
c) release of histamine a)dilatation of arterioles e) localized redness b)increase capillary permeability d) escape fluid from blood vessels f) localized swelling
Cromolyn sodium acts by preventing ____ ions from entering mast cells, thus preventing the release of inflammatory mediators.
calcium
when the SABA drugsare administered to older adults there is an increased risk of_____
cardiovascular effects
A patient revieves a prescription for (pheylephrine Neo Synephrine) The nurse explains that the overuse if this drug may_____
caused rebound nasal congestion
opioid analgesics-interaction
causes additive central nervous system (CNS) depressant effect
example of antitussive
codeine and dextromethorphan
A nurse is caring for a patient with ineffective airway clearance at a health care facility.
cough lasts more than 10 days
a____is a drug that reduces the swelling of the nasal passages, which, in turn, opens clogged nasal passages and enhances drainage of the sinuses.
decongestant
Aluminum -based antacids -interaction
decreases the concentration of the antihistamines
Antitussive are medications that?
depress the cough in the center of the brain
A patient with a cough visit a health care facility and is prescribed an antitussive. which of the following reactions associated with the antitussive administration should the nurse monitor for in the patient.
diarrhea
methylxanthines stimulate the central nervous system to promote____of the bronchi.
dilatation
which of the following elicits its antihistamine effects by non-selectively binding to central and peripheral H1 receptors?
diphenhydramine
Diphenhydramine (benadryl) adverse reaction
drowsiness, dry mouth, anorexia, blurred vision, urinary frequency
Complication of inhale corticosteroids and mast cells are?
during period of stress or server asthmatic attack patients who have been withdrawn from systemic corticosteroid should be instructed to resume systemic steroids immediately and to contact the PCP. death can occur
A patient is prescribed aminophylline for emphysema. Which of the following factors should the nurse assess to check for the occurrence of any adverse effects.
electrocardiograph changes
A nurse is caring for a patient with ineffective airway clearance at a health care facility. Which of the following is an appropriate nurse's role to promote effective airway clearance?
encourage fluid intake up to 2000 mL per day
a physician has prescribed acetylcsteine for the patient. The drug is to be inserted into the tracheotomy Nurse role?
ensure the suction equipment is at the patient bedside
_____is a drug that aids in raising thick, tenacious mucus from the respiratory passages.
expectorant
which of the following statement is appropriate for the nurse to include in discharge instructions for a patient taking an antitussive?
frequent sips of water may diminish coughing
Which drug is classified as an expectorant?
guaifenesin
patient under going dextromethorphan therapy. Pt also needs to be administered MAOI's inhibitors for the treatment of depression. what risk factor with the interaction of the two drugs should the nurse observe in patient?
hypotension
MAOI inhibitors-interaction
increase the anti-cholingeric and sedation effects of antihistamines
beta-blockers-interaction
increase the risk of cardiovascular effects
which of the following interactions would you most likely occur when diphenhyramine is administered with a B blocker drug such as Propranolol (Indrea)
increased risk for increased cardiovascular effects
A patient has been prescribed an antihistamine drug to be given paternally. Which of the following routes of drug administration should the nurse prefer?
intramuscular
expectorant
is a drug that reduces swelling of the nasal passages which in turn opens clogged nasal passages and breaks up thick mucus/enhances drainage of sinuses ex. guaifenesin (Robitussin)
decongestant
is a drug that reduces swelling of the nasal passages which in turn opens clogged nasal passages and enhances drainage of sinuses
antitussive
is a drug used to relieve coughing ex. (benzonatate) tessalon
A nurse is assigned to care for a patient who has been prescribed an antitussive. In which of the following conditions is the use of antitussives contraindicated
liver dysfunction
Which of the following may increase the risk of asthma-related death?
long acting B2 agonist
asthma medication categories
long term and quick relief
The patient should avoid drinking fluids for 30 mins after the use of _____ to avoid losing effectiveness of the drug.
lozenge
which of the following reduces the effect of antihistamines
magnesium-based antacids
in allergic or hyposentivity reactions, histamine is released from the ______ cells.
mast
A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions?
mucolytic
mucolytic and expectorant implementation
mucolytic acetylcysteine is administered by neb inform pt that medication smells like rotten eggs remain with patient for first treatment keep suction equipment at bedside for trach pt
In asthma, the airways become narrow and extra ___ clogs the smaller airways.
mucus
mucolytic patient education
normally used in the hospital but may be prescribed for a patient going home who's renting equipment for therapy
mucolytic and expectorants ongoing assessment
nurse auscultates the lungs and record the findings evaluate pt respiratory status
Bronchodilators
occur when B-adrenergic receptors are stimulated. Some theories propose that asthma used as broncho-dilators have the sub classification of B2 receptor agonist, which are short acting Albuterol and Terbutaline
A patient with asthma has been prescribed the use of montelukast orally. When should the nurse instruct the patient to take the drug?
once a day
How should montelukast is administers
once a day in the evening
The ____antitussive are contraindicated in premature infants or drug labor when delivery of a premature infant is anticipated.
opioid
Precautions Expectorants
pregnancy-lactation server respiratory insufficiency debilitated patients
A hospitalized patient may occasionally have an antitussivve preparation prescribed especially when a non-productive cough causes:
raising pressure in the eye (increased intraocanial pressure) after eye surgery or increasing intracranial pressure in those with CNS disorders
rifampin-interaction
reduces the absorption of certain antihistamines
acetylcysteine uses
reduction of viscosity of mucus in acute and chronic broncho-pulmonary disease and diagnostic bronchial studies, acetaminophen toxicity
guaifensin uses
relief of cough associated with respiratory tract infection , especially when the cough is dry and non-productive
codeine sulfate uses
relief of mild to moderate pain
antitussive are used to
relieve non productive coughs
A mucolytic is a drug that loosens_____secretions
respiratory
when administering aminophylline a xanthine derivative bronchodilating drug, the nurse monitors the patient for adverse reactions which include_____.
restlessness and nervousness
Antihistamines that penetrate the blood-brain barrier minimally exhibit fewer _____effects.
sedating
codeine sulfate adverse reaction
sedation nausea, vomiting, dizziness, CNS depression, constipation
Bezonatate (Tessalon)
sedation, headache, mild dizziness, constipation, nausea, GI upset, pruritus, nasal congestion
Xanthine derivatives elicit their effect by which of the following mechanisms?
stimulation of the central nervous system
Acetylcysteine adverse reaction
stomatitis, nausea, vomiting, sever drowsiness broncho-spasm irritation of the trachea and bronchi
diphenhydramine HCI uses
symptomatic relief of coughing caused by irritation
a pregnant client is admitted to health care facility with acute respiratory distress. Which of the following drugs should the nurse consider as relatively safe for such a patient?
terbutaline
expectorants elicit their effect by which of the following mechanisms?
thinning respiratory secretions
expectorants elicit there effect by which of the following mechanisms?
thinning respiratory secretions
what is the purpose/ mechanism of the respiratory system?
to exchange oxygen and carbon dioxide in the lungs
what information should be obtained from the client by the nurse and documented prior to the administration of antitussive?
type of cough presence of sputum color and amount of sputum home remedies used to treat the cough vital signs
Nasal decongestants produce localized _____ of the small blood vessels of the nasal membranes.
vasconstriction
Decongestants elicit there effect by which of the following mechanisms?
vasconstriction of small blood vessels of the nasal membrane
The three most common symptoms of asthma cough, dyspnea and ____.
wheezing