Chapter 32 Prep U

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? "Be sure to take this medication on a full stomach." "Determine if the drug is going to make you drowsy before you drive." "You should take the medication twice a day." "This drug has to be taken every 4 to 6 hours."

"Determine if the drug is going to make you drowsy before you drive."

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? "If I miss a dose of medication, I will wait until the next scheduled time to take the medication." "I will take this medication with apple juice." "I will be careful to take the medication exactly as it comes." "I will check the prescription bottle and follow the directions carefully."

"I will take this medication with apple juice."

A client exhibiting signs and symptoms of the common cold asks the nurse if taking an antihistamine would be helpful. What is the nurse's best response? Yes, but be sure to use a brand that mentions 'cold remedy' on the packaging. Yes, but it's important to monitor for adverse effects. Antihistamines can be helpful when they're combined with an antibiotic. Antihistamines are not recommended for treating a cold.

Antihistamines are not recommended for treating a cold.

Second-generation antihistamines were developed to remove the sedation of first generation drugs. Which of the following antihistamines is a second-generation drug? Dexchlorpheniramine Chlorpheniramine Cetirizine Diphenhydramine

Cetirizine

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? Central nervous system depression Hypotension Nausea and vomiting Joint pain

Nausea and vomiting

A client reports nasal congestion, sneezing, watery drainage from the nose, and itching of the throat, eyes, and ears. The nurse recognizes that these are consistent with what disorder? sinus infection allergic rhinitis anaphylaxis a histamine reaction

allergic rhinitis

The nurse reviews the client's medical history before providing medications. Which antihistamine would the nurse question before providing a dose to the client? cetirizine azelastine fexofenadine diphenhydramine

diphenhydramine

The substances released from mast cells are responsible for what physiological response? Select all that apply. myalgia inflammation bronchoconstriction smooth muscle dilation decreased capillary permeability

inflammation bronchoconstriction

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? "Taking this medication shouldn't stop me from having my after-dinner drink." "It's safe to take this medication with the nighttime sinus medication that I've been using." "I should avoid driving after taking this medication." "This medication has no serious side effects."

"I should avoid driving after taking this medication."

The nurse is teaching a client about the potential for allergic drug reaction. What statement made by a client suggests a need for further teaching? "All drugs have the potential to cause an allergic reaction." "The additives that are in drugs can also cause allergic reactions." "Virtually any drug may induce an immunologic response in a susceptible person." "If you didn't have allergies as a child, you won't develop allergies later in life."

"If you didn't have allergies as a child, you won't develop allergies later in life."

A professor of pharmacology has just completed her lecture regarding hypersensitivity (allergic) responses. Her lecture focused on Type IV reactions. Which of the following statements made by her students will show that the students understood the material? Choose all that apply. "It is also called delayed hypersensitivity." "It is a cell-mediated response in which sensitized T lymphocytes react with an antigen to cause inflammation." "The test for TB is this type of reaction." "This reaction occurs immediately after exposure to the antigen."

"It is also called delayed hypersensitivity." "It is a cell-mediated response in which sensitized T lymphocytes react with an antigen to cause inflammation." "The test for TB is this type of reaction."

A nursing professor has just completed her lecture regarding hypersensitivity (allergic) responses. Her lecture focused on Type III reactions. Which of the following statements made by her students will show that the students understood the material? Choose all that apply. "It is an IgG- or IgM-mediated reaction that forms antigen-antibody complexes that kicks in inflammation in the tissue." "Serum sickness is the prototype of these reactions." "This is a mild type of reaction that cannot do any harm to the body." "Anaphylaxis is an example of this type of reaction."

"It is an IgG- or IgM-mediated reaction that forms antigen-antibody complexes that kicks in inflammation in the tissue." "Serum sickness is the prototype of these reactions."

The nurse is providing education to a client regarding the use of an over-the-counter (OTC) antihistamine. Which client statement demonstrates a need for additional teaching? "I take the medication to manage my itchy, watery eyes." "When I feel a cold coming on, I know to take an antihistamine." "When I know I'm going to spend time outdoors, I take an antihistamine." "I always need an antihistamine when I visit family members who own pets."

"When I feel a cold coming on, I know to take an antihistamine."

A client whose daily commute includes travel on a ferry boat has been prescribed diphenhydramine. During client teaching, the nurse should instruct the client to take the medication at what time? 30 to 60 minutes before the ferry trip the night before each trip as soon as the ferry leaves the dock when the client boards the ferry

30 to 60 minutes before the ferry trip

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 Stopping the drug after 3 days if no relief is obtained Encouraging the client to engage in usual activities such as driving

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

A client has taken antihistamines for seasonal allergies for many years and has recently switched from diphenhydramine to cetirizine. The client states, "I'm so happy to get some relief without feeling sleepy all the time." The nurse should attribute this to what characteristic of cetirizine? Cetirizine does not readily cross the blood-brain barrier. Cetirizine stimulates the sympathetic nervous system. Cetirizine depresses the parasympathetic nervous system. Cetirizine slows the reuptake of serotonin.

Cetirizine does not readily cross the blood-brain barrier.

A hospital client has developed a hypersensitivity reaction to a medication and the health care provider has prescribed "diphenhydramine 50 mg SC." What is the nurse's best action? Clarify the route of administration with the health care provider. Confirm whether the health care provider instead intended to prescribe dimenhydrinate. Question the health care provider about the dose. Administer the medication as prescribed and monitor the client.

Clarify the route of administration with the health care provider.

The nursing instructor is describing the four types of hypersensitivity reactions. What alternate name might the instructor use to identify type IV hypersensitivity? Immediate hypersensitivity Delayed hypersensitivity Serum sickness Cytotoxic reaction

Delayed hypersensitivity

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? Cetirizine Desloratadine Azelastine Diphenhydramine

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 non-selectively binding to central and peripheral H1 receptors? Diphenhydramine Cetirizine Fexofenadine Loratadine

Diphenhydramine

The health care provider has prescribed medication to prevent posttransfusion reaction in a client with a history of the disorder. Which medication would the nurse anticipate being administered? Epinephrine Furosemide Diphenhydramine Ibuprofen

Diphenhydramine

A client has begun taking an antihistamine for the treatment of seasonal allergies. What dietary guidelines should the nurse provide to the client? Do not drink alcohol while taking antihistamines. Avoid grapefruit juice until at least 48 hours after treatment is complete. Increase intake of foods that are high in vitamin C. Eat several small meals instead of three larger meals a day.

Do not drink alcohol while taking antihistamines.

A 76-year-old client has been prescribed an oral antihistamine. What adverse effect presents a priority safety concern for older adult clients? Drowsiness Dry mouth Nasal burning Nonproductive cough

Drowsiness

A female client is prescribed a first-generation antihistamine for her allergies. The nurse would expect her to experience what adverse effect? Diarrhea Incontinence Dry mouth Slurred speech

Dry mouth

The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects? Dry mouth Blurred vision Excessive salivation Drowsiness

Excessive salivation

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? Removing environmental allergens Administering the antihistamine Ensuring that the patient uses a second-generation antihistamine Helping the patient identify environmental allergens

Helping the patient identify environmental allergens

Which statement accurately describes an aspect of serum sickness? It can develop in 1 to 2 days. Sensitization to the antigen will diminish the reaction. Is a delayed hypersensitivity reaction. Symptoms include sensitivity to light resulting in optic pain.

Is a delayed hypersensitivity reaction.

The nurse is caring for a client who has been diagnosed with allergic rhinitis and takes clemastine daily. What should the nurse teach the client about the action of the medication? It blocks the effects of histamine. It changes the viscosity of mucus. It promotes the development of mast cells. It increases the tone of smooth muscle in the bronchi.

It blocks the effects of histamine.

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? Brompheniramine Promethazine Meclizine Loratadine

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? Brompheniramine Clemastine Chlorpheniramine Loratadine

Loratadine

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? Observe for swelling in nasal passages. Ask about history of hay fever. Obtain the client's blood pressure. Ask about nausea and vomiting.

Obtain the client's blood pressure.

An older adult client is administered dimenhydrinate. Which is the priority nursing intervention for this client? Encourage fluids with this client. Have the client void after administration. Maintain IV access. Protect from injury.

Protect from injury.

The nurse is teaching a group of clients with allergic rhinitis (hay fever) about medication use. What would be the most essential information to give these clients about preventing possible drug interactions? Over-the-counter (OTC) medications are safe to use. Use only one pharmacy so the pharmacist can check drug interactions. Read drug labels before taking OTC medications. Ask a health care professional for assistance in selecting an OTC medication.

Read drug labels before taking OTC medications.

What type of antihistamine is typically preferred for older adults? First-generation Second-generation Neither type is preferred over the other. Antihistamines are contraindicated in older adults.

Second-generation

When describing the effects of second-generation antihistamines, which would the nurse address as being decreased? Hypersensitivity Dry mouth Gastrointestinal upset Sedation

Sedation

A 15-year-old patient is prescribed an antihistamine for allergic rhinitis. However, antihistamines used to treat allergic reactions may themselves cause allergy. The nurse needs to educate the patient to be aware of symptoms suggesting allergy. Which of the following is an allergic reaction to antihistamines? Dryness of mouth Drowsiness and sedation Skin rash and urticaria Disturbed coordination

Skin rash and urticaria

An older adult client informs the nurse that they have been taking diphenhydramine for the treatment of seasonal allergies for the past several days. What aspect of this client's health status will the nurse identify as a safety risk related to this medication? The client takes medication to treat benign prostatic hypertrophy (BPH). The client was treated for testicular cancer 8 years ago. The client has a history of falls during the night. The client has type 2 diabetes, controlled with diet. The client has allergies to penicillin and ibuprofen.

The client takes medication to treat benign prostatic hypertrophy (BPH). The client has a history of falls during the night.

Second-generation H1 antagonists cause less CNS depression because they are selective for peripheral H1 receptors and because of which other property? They are excreted by the renal system. They are metabolized by the liver. They cross the blood-brain barrier. They do not cross the blood-brain barrier.

They do not cross the blood-brain barrier.

What is one of the benefits related to second generation antihistamine administration in older adults? They do not impair thinking. They reduce the number of falls in clients diagnosed with osteoporosis. They increase the ability of clients with dementia to perform ADLs. They do not affect oxygenation.

They do not impair thinking.

Which client is most likely to benefit from the administration of a nasal steroid? a client with an acute sinus infection a client who has chronic allergic rhinitis (hay fever) a client who is recovering from a tonsillectomy a client who has a deviated nasal septum

a client who has chronic allergic rhinitis (hay fever)

A 20-year-old woman calls the clinic at 5 PM and reports to the nurse that she forgot to take her morning dose of fexofenadine (Allegra). She usually takes her evening dose at 8 PM. She wants to know what she should do. The nurse will instruct her to double her evening dose. skip the evening dose and start back in the morning. forget about the morning dose and take the evening dose. take the morning dose now and the evening dose at the regular time.

forget about the morning dose and take the evening dose.

A client has an important presentation to make in 4 hours and needs relief from the congestion of seasonal rhinitis. The client calls the nurse and explains the situation, saying, "I cannot afford to be drowsy." What medication is most likely to meet this client's needs? diphenhydramine dexchlorpheniramine loratadine hydroxyzine

loratadine

A client has reported worsening seasonal allergies to the nurse and has asked for guidance about whether to take over-the-counter diphenhydramine. When reviewing the client's current medication regimen, the nurse will address which medication? calcitonin alendronate lorazepam clopidogrel

lorazepam

The nurse regularly assesses clients for risk of anaphylactic reaction to prescribed medications. The nurse is aware that such reactions most commonly occur with what type of medication? opioid analgesics local anesthestics penicillins vaccines

penicillins

A client has been prescribed a first-generation antihistamine. What adverse effects should the nurse describe during client teaching? Select all that apply. sense of euphoria urinary retention diarrhea blurred vision dry mouth

urinary retention blurred vision dry mouth