Ch 54: Drugs Acting on the Upper Respiratory Tract

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

The nurse is planning care for a client who is experiencing excessive respiratory tract secretions. What intervention should the nurse include?

deep breathing and coughing exercises

Which condition would contraindicate the use of oxymetazoline?

hypertension

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."

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."

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."

After teaching a client who is receiving an antitussive about the drug, which statement indicates the need for additional teaching?

"I'll keep the room warm and toasty."

A client has hypertension and wants to take a nasal decongestant for cold symptoms. Which statement by the nurse indicates the effect of hypertensive medications on hypertension?

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

The nurse is educating an adult client diagnosed with rhinosinusitis with viscous clear mucous about the prescribed guaifenesin 400 mg PO every 4 hours. Which statement made by the client establishes the need for further clarification?

"The drug will suppress my cough so I can sleep easier."

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

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.)

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

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

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

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

30 minutes

The nurse instructs a client who is prescribed a nasal steroid that it may take up to how long before effects may be noted?

7 days

A client asks the nurse about using dextromethorphan to relieve a cough. What type of cough would the nurse explain is best treated with the drug?

A dry, nonproductive cough

A client is admitted after overdose with acetaminophen. What medication would the nurse expect to be administered?

Acetylcysteine

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 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 client is experiencing allergy symptoms after being exposed to environmental dust. This reaction involves the action of histamine, which is released by what cells?

Basophils

A nurse is caring for a patient who has been prescribed a nasal decongestant. Which of the following factors should the nurse assess before administering the drug?

Blood pressure

Which should be observed during ongoing assessment of a client taking a decongestant? (Select all that apply.)

Blood pressure Level of congestion Therapeutic effect

When instructing a client in how to use a topical nasal spray, what would the nurse emphasize to do first?

Clear the nasal passages.

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.

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 calls the clinic and reports symptoms of a cold. The client is most concerned because the cold symptoms are preventing him from sleeping. The nurse would inform the client that what medication relieves cold symptoms and aids sleep?

Diphenhydramine

A nurse is describing the action of a prescribed antihistamine to a client. The nurse is describing which medication, by explaining that the drug elicits its antihistamine effects by nonselectively binding to central and peripheral H1 receptors?

Diphenhydramine

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

The nurse is assessing a client suspected of overdose with dextromethorphan. What assessment finding is suggestive of an overdose with the drug?

Hallucinations

A client with allergies has expressed interest in taking pseudoephedrine for seasonal allergies. What client condition would most strongly lead the nurse to caution against taking the drug?

History of severe hypertension

The physician has order promethazine (Phenergan) for a client who is nauseated and vomiting. Which would be an appropriate route of administering promethazine to the client? (SATA)

Intramuscularly Intravenously

A client who has been suffering from repeated sinus infections is diagnosed with allergic rhinitis and prescribed a daily antihistamine. What is the mechanism of action in the antihistamine medications?

It prevents histamine from acting on target tissues.

A group of students are reviewing information about antihistamines. The students demonstrate understanding of the information when they identify which agent as a second generation antihistamine?

Loratadine

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

A female client calls the pediatrician's office for a suggestion regarding the best over-the-counter cough and cold medicine for her 6-month-old child. The pediatrician advises against the medication for what reason?

Misuse could result in overdose.

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

Which would the nurse expect to administer as a nasal spray?

Oxymetazoline

An older adult client is administered dimenhydrinate. Which is the priority nursing intervention for this client?

Protect from injury.

A client reports anxiety, restlessness, nausea, and vomiting after using a nasal decongestant. Which drug should the nurse consider as the cause for these side effects?

Pseudoephedrine

A male client is diagnosed with chronic bronchitis. What would the nurse expect to be one of his physical reports?

Retention of secretions

An instructor is describing topical decongestants as belonging to which class?

Sympathomimetics

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.

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.

A 21-year-old patient reports a mild stinging sensation on using a nasal spray containing a nasal decongestant. Which information should the nurse provide the patient?

This sensation usually disappears with continued use.

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

True

The nurse is educating an adult client diagnosed with a nonproductive cough about the prescribed dextromethorphan. Which statement made by the client establishes the need for further clarification?

"I will dilute the drug syrup with an equal amount of water."

The nurse is caring for a client with cystic fibrosis who is receiving dornase alfa by nebulizer to help thin secretions. What statement by the client indicates a need for further instruction?

"I'm glad that this medication will address all of my symptoms."

The nurse is providing education for a client who has been prescribed a second-generation antihistamine. Which client statement suggests a need for additional teaching?

"I'm really hoping that these pills will cure my allergies before summer starts."

There are two types of antitussives, centrally acting and peripherally acting. Which are centrally acting antitussives? (Select all that apply.)

- Codeine - Dextromethorphan

The nurse would caution clients with which disorders to avoid the use of over-the-counter pseudoephedrine? (Select all that apply.)

- Diabetes - Cardiovascular disorders - Glaucoma

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.)

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

When the use of antihistamines result in dryness of the mouth, the nurse should recommend which to relieve the dryness? SATA

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

A client diagnosed with allergic rhinitis has expressed a lack of interest in treating the disorder. When providing client teaching, what should the nurse identify as potential effects of avoiding treatment? Select all that apply.

- chronic fatigue - insomnia - sinusitis - asthma

The health care provider suggests that a client use guaifenesin to help his cough. The nurse instructs the client to call the health care provider if he continues to have a productive cough after which amount of time?

1 week

What should be observed during ongoing assessment of a client taking an antitussive? (Select all that apply.)

Frequency of cough Pain assessment Therapeutic effect Lung sounds

A client diagnosed with the common cold asks the nurse about taking an over-the-counter (OTC) cold medications. What statement should the nurse include in client teaching?

"Follow the instructions on the label so that you don't end up making the congestion worse."

The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects?

Excessive salivation

Which is classified as a decongestant?

Oxymetazoline (Afrin)

Some antihistamines can produce significant sedation. Which drug is most likely to cause this adverse effect?

Promethazine

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 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

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