Chapter 54- Drugs Acting on the Upper Respiratory Tract

The nurse is caring for a patient who does not have a respiratory disorder but has been prescribed acetylcysteine. What is an additional indication for acetylcysteine (Mucomyst)?

Antidote for acetaminophen poisoning

A student nurse is doing research consisting of chart audits of 25 patients with diagnosed chronic pharyngitis; she is attempting to determine what medication has been prescribed most frequently. What type of medication would this nurse expect to find in most of the chart audits?

Antitussives

The nurse is caring for a patient who is scheduled to receive acetylcysteine because of an acetaminophen overdose. The nurse would notify the physician before administering the medication if the patient had which condition? (Select all that apply.)

Bronchospasm. Peptic ulcer. Esophageal varices.

A 71-year-old man with a history of heart disease and diabetes has had an antihistamine prescribed. The nurse is concerned with this prescription because of the risk for what?

Cardiac arrhythmias

A patient comes to the clinic with symptoms as seen in a cold. What group of upper respiratory drugs causes local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow?

Decongestants

A patient presents at the clinic with a dry nonproductive cough. The patient is diagnosed with bronchitis and it has been determined that assistance is needed in thinning the sputum so the cough can become productive. What does the nurse expect the physician will prescribe?

Guaifenesin (Mucinex)

The nursing instructor is teaching the lab students the best position for the administration of nasal sprays. What position would the instructor teach the students?

High Fowlers

A nurse in a three drops with respiratory problems has received orders for four patients. What medication order will the nurse question?

Hydrocodone (Hycodan) 10 mg PO for a 5-year-old child

What disorders would the pharmacology instructor tell the nursing students may be exacerbated by the use of nasal decongestants?

Hypothyroidism

What statement by the patient leads the nurse to believe that he needs additional instruction regarding his nasal decongestant?

I will use it only when I have nasal discharge.

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

Im glad that this medication will solve all of my problems.

A 29-year-old female patient has sinusitis, so the physician orders a topical nasal decongestant. What instructions should be given?

Increase fluids to 2 L/d.

The nurse is giving discharge instructions to the mother of a 3-month-old infant who has an upper respiratory tract infection and has been prescribed a pseudoephedrine nasal solution. What instructions are most important for the nurse to give to this mother?

Instill the medication 20 to 30 minutes before feeding.

The nurse is caring for a patient who needs education on his medication therapy for allergic rhinitis. The patient is to take clemastine (Tavist) daily. In providing educational interventions regarding this medication, what is the most important instruction on the action of the medication?

It blocks the effects of histamine.

A patient presents at the clinic with signs and symptoms of seasonal allergic rhinitis. The patient is prescribed a nasal steroid to relieve symptoms. Two days later, the patient calls the clinic and tells the nurse that he is frustrated and wants a new drug. What is the most appropriate response by the nurse?

It may take up to 2 weeks to get the full clinical effect. Try to keep using the drug as ordered.

he clinic nurse is caring for a patient who has been prescribed fexofenadine for hay fever. When the nurse is assessing this patients medication history, what drug would make the nurse question the order for fexofenadine?

Ketoconazole

A patient has an important presentation to make in 4 hours and he needs relief from the congestion of seasonal rhinitis. The patient calls the nurse, explains the situation, and tells the nurse that he cannot afford to be drowsy. Which antihistamine would be a good choice for this patient?

Loratadine (Claritin)

Parents who treat their childrens cold and flu symptoms at home should be educated concerning the reading and understanding of over-the-counter (OTC) labels. Why is this statement true?

Many of these preparations contain the same active ingredients so that inadvertent overdose is a common problem.

The nurse is caring for a patient who is taking dextromethorphan for cough suppression. The nurse will assess this patient for hypotension if he also takes which other medication?

Monoamine oxidase (MAO) inhibitors

The nurse advises that patient to avoid long-term use of nasal decongestants because it may lead to what condition?

Mucosal ulcerations

A patient has been prescribed a nasal steroid and asks the nurse what the most common reason that this medication is used to treat. What is the nurses best response?

Nasal steroids are used to treat allergic rhinitis.

A patient has been using guaifenesin for a cough that accompanied a common cold. The patient calls the nurse help line and states that she thinks she is having an adverse reaction to the medication. The nurse knows that which symptoms are adverse effects of this medication? (Select all that apply.)

Nausea. Rash. Headache.

The pharmacology instructor questions the students as to which classification of drugs is commonly found in over-the-counter (OTC) combination cold medications?

Oral decongestants

The nursing instructor is discussing the administration of nasal spray with the nursing students. What information is most important to include in this discussion?

Overuse of nasal spray may cause rebound congestion.

The family nurse practitioner is caring for a Hispanic woman who is 83 years old. The patient has been noncompliant with the care regimen the nurse practitioner has previously outlined for treatment of sinusitis. What should the nurse practitioner do that can assist the patient in being more compliant with the prescribed treatment regimen?

Provide instructions in writing.

The nurse is teaching a group of patients with allergic rhinitis about the use of their medications. What would be the most essential information to give these patients about preventing possible drug interactions?

Read drug labels before taking OTC medications.

The nurse is giving discharge instructions to a patient with an upper respiratory infection who has been advised to take an over-the-counter (OTC) topical nasal decongestant. The nurse advises the patient about what common adverse reaction to these medications?

Rhinitis medicamentosa

The nurse is caring for a patient who is receiving acetylcysteine (Mucomyst) by face mask. What would be an appropriate nursing diagnosis?

Risk for impaired skin integrity

The nurse is writing a care plan for a patient who has been prescribed a nasal steroid. What would be an appropriate nursing diagnosis for this patient?

Risk for injury related to suppression of inflammatory reaction

A nurse is caring for a 15-year-old patient with cystic fibrosis who has been prescribed dornase alfa (Pulmozyme) to relieve the buildup of secretions and keep airways open and functioning longer. What will the nurse instruct the patient to do concerning the use of this drug?

Store the drug in the refrigerator, protected from light.

What statement by a 61-year-old patient who is to take an antitussive with codeine indicates that the nurses teaching has been effective?

This medication can cause drowsiness, so I will avoid driving or using power equipment while I take it

A patient has been prescribed an antihistamine for treatment of allergic rhinitis. What statements by the patient indicate an understanding of this medication? (Select all that apply.)

This medication will work best if I take it before I eat anything. I will use sugarless candies to help with the feelings of a dry mouth. I will use a humidifier in the bedroom while I sleep.

A patient visits the clinic and is diagnosed with acute sinusitis. To promote sinus drainage, what medication might be ordered?

Topical decongestants

An individual calls the nurse help line and asks what the drug diphenhydramine is used for. The nurse knows that the medication is prescribed for which conditions? (Select all that apply.)

Urticaria. Vasomotor rhinitis. Motion sickness. Angioedema.

What would be the nurses best response if a patient calls the clinic and reports that he has had a persistent cough for 2 weeks and asks the nurse for a recommendation for a cough medicine?

You should come to the clinic to be evaluated. A cough that lasts that long might be an indication of an underlying medical problem.