PrepU Chapter 54: Drugs Acting on the Upper Respiratory Tract

Which statement by the client would alert the nurse that more education is needed regarding a client receiving an antitussive?

"I should keep the room warm."

An older client diagnosed with hypertension is requesting an oral nasal decongestant for cold symptoms. Which statement by the nurse best describes the effect of decongestants on blood pressure?

"The administration of a nasal decongestant will increase blood pressure due to vasoconstriction of blood vessels."

After teaching a group of parents about the use of over-the-counter cough and cold products with their children, which statement indicates the need for additional teaching?

"We can use the adult brand, but we just have to decrease the amount."

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

"Consult with your primary care provider."

What principle should guide the nurse's response when a parent asks about the use of an antitussive to treat a 7-year-old's dry cough?

Antitussives are not recommended for use in young children

A client asks, "What is the difference between antitussive medications and expectorants?" What information should the nurse's response be based upon?

Antitussives suppress coughing while expectorants loosen bronchial secretions

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.)

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

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

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

The nurse's assessment should prioritize what system when caring for a client who has just been admitted for an overdose of pseudoephedrine?

Cardiovascular

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

Clemastine Dimenhydrinate

A client comes to the clinic with what appears to be a cold. What group of upper respiratory drugs cause local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow?

Decongestants

When describing the benefits of second-generation H1 receptor antagonists to those of first-generation H1 receptor antagonists, the nurse should cite what advantage?

Decreased sedation

A client prescribed codeine for a persistent, debilitating cough tells the nurse, "I was sure that codeine was a narcotic that people take for pain." The nurse should cite what mechanism of action when describing this use of codeine?

Depression of the cough center in the medulla oblongata

An adult client has reported experiencing a dry mouth and urinary retention after several nights of taking an over-the-counter (OTC) sleep aid. The nurse should suspect that this medication contains what antihistamine?

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?

Diphenhydramine

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

A female client presents at the clinic with a dry, nonproductive cough. The client 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 will be prescribed for the client?

Guaifenesin

What is the chemical mediator released in immune and inflammatory response to allergic reactions?

Histamine

Which condition would contraindicate the use of or oxymetazoline?

Hypertension

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

Mucolytic

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?

Nausea and vomiting

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 would the nurse expect to administer as a nasal spray?

Oxymetazoline

A patient is advised to take a decongestant drug to relieve nasal congestion associated with hay fever. The patient is not comfortable with a nasal spray or drops and prefers an oral tablet. Which oral decongestant drugs can be administered to the patient?

Pseudoephedrine

A client reports experiencing severe nasal congestion since starting to use an over-the-counter (OTC) nasal decongestant spray a week ago. This symptomology most supports what possible medical condition?

Rebound congestion

A male client presents to the health care provider'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

A gerontological nurse has encouraged a group of caregivers who work with older adults to avoid administering first-generation H1 receptor antagonists to their clients. The nurse's cautionary message is an acknowledgment of what possible nursing diagnosis?

Risk for falls related to sedation

A group of students demonstrate understanding of topical decongestants, identifying them as:

Sympathomimetics

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

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

True

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

True

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

30 minutes

A client with a respiratory tract infection is prescribed expectorants. A nurse should administer expectorants cautiously in clients with:

A persistent cough

What medication would be administered to counteract the effect of acetaminophen?

Acetylcysteine

What home remedies are effective for mouth dryness and cough? (Select all that apply.)

Adequate fluid intake Humidification of the environment Sucking on hard candy or throat lozenges

When developing the teaching plan for a client receiving an antihistamine, which would the nurse include? (Select all that apply.)

Advising the client to avoid alcohol consumption Using sugarless candies or lozenges to combat dry mouth

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

Antidote for acetaminophen poisoning

The nursing instructor is teaching about antitussives and their side effects. What ingredient found in some antitussives does the instructor tell students can cause drowsiness?

Antihistamine

A client in the renal unit has developed allergic rhinitis. The health care provider has ordered fexofenadine 60 mg twice daily. What is the priority nursing action in this situation?

Contact the provider

A client, having an allergic reaction to mold, describes chest tightness and difficulty breathing. Which body effect is occurring?

Contraction of smooth muscle in the bronchi

Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine?

Ineffective airway clearance

A client has expressed frustration stating, "I've been taking an over-the-counter (OTC) decongestant for several days and it still hasn't really cured my cold." What teaching point should the nurse convey to the client?

"Drugs like this can often relieve some of the symptoms of a cold, but they won't cure it."

The nurse is educating an older adult client diagnosed with rhinosinusitis in an outpatient clinic about the prescribed topical oxymetazoline. The client has a history of hypertension and coronary artery disease. Which statement made by the client establishes the need for further clarification?

"I can take over-the-counter pseudoephedrine, too."

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?

"I should avoid driving after taking this medication."

A client, scheduled to receive one unit of packed red blood cells, has a history of an allergic reaction to a transfusion in the past. What class of medication will assist in preventing a reaction to the packed red blood cell transfusion?

Antihistamines

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

An adult client has asked the nurse to recommend an OTC cold remedy. Before making a recommendation, the nurse should implement which intervention?

Assess the client for health problems that may contraindicate the use of a particular remedy

Which agent would the nurse identify as providing local anesthesia to the respiratory passages?

Benzonatate

A 76-year-old client has been prescribed an oral antihistamine. What adverse effect presents a priority safety concern for older adult clients?

Drowsiness

A group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example?

Guaifenesin

Mr. Zee is prescribed an inhaled nasal steroid to relieve his symptoms associated with seasonal allergies. What is true about inhaled nasal steroids?

Inhaled nasal steroids are more effective than oral medications in treating the global symptoms associated with allergies

A client reports increased sedation after the initiation of chlorpeniramine to treat her allergies. Which antihistamines could the nurse recommend to the client to treat her allergy symptoms that would result in less sedation? (Select all that apply.)

Loratadine (Claritin) Cetirizine (Zyrtec)

A client 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

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

Meclizine

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

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

A client informs the nurse about taking pseudoephedrine for the relief of nasal congestion due to the common cold. In which situation should the nurse suggest that the client not use this medication since it is a contraindication for this health care concern?

The client is being treated for severe hypertension

When describing the action of decongestants, a nurse integrates knowledge of this class of drugs, identifying which mechanism?

Vasoconstriction of small blood vessels of the nasal membranes

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

Pseudoephedrine

A client is prescribed an antitussive agent with codeine. Which statement by the client indicates that the nurse's teaching has been effective?

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