CH 32 Drugs to Decrease Histamine Effects and Allergic Response (E2)
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? A) risk for infection related to adverse effects of antihistamines B) risk for falls related to sedation C) risk for deficient fluid volume related to diuresis D) risk for impaired skin integrity related to urticaria
B
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? A) lymphocytes B) CD4 T cells C) basophils D) platelets
C
A client is being prescribed epinephrine for the treatment of anaphylaxis. This client is experiencing what type of hypersensitivity reaction? A) type I B) type II C) type III D) type IV
A
A client, having an allergic reaction to mold, describes chest tightness and difficulty breathing. Which body effect is occurring? A) contraction of smooth muscle in the bronchi B) suppression of the vagus nerve endings producing tachycardia C) decreased permeability of the veins and capillaries D) decreased secretion of the mucous glands
A
A patient has asked for an antihistamine to relieve symptoms of an upper respiratory infection. The nurse explains that studies have demonstrated that for treatment of the common cold, which of the following is true of antihistamines? A) are effective in relieving cold symptoms B) do not relieve symptoms and are not recommended C) should be compounded with other products to be effective D) relieve nonallergenic symptoms only
B
The nurse receives an order to administer diphenhydramine. This medication is recommended for use in which of the following? A) premature or full-term infants B) adults to prevent allergic reactions C) children with chickenpox D) children with a flulike infection
B
What effect is associated with a first-generation H1 receptor antagonist? A) It depletes norepinephrine and serotonin. B) It decreases capillary permeability. C) It catalyzes the enzymatic oxidation of uric acid. D) It raises the seizure threshold by impairing vitamin D.
B
When describing the benefits of second-generation H1 receptor antagonists to those of first-generation H1 receptor antagonists, the nurse should cite what advantage? A) lower cost B) decreased sedation C) absence of adverse effects D) once-weekly dosing
B
Which client statement suggests a need for addition education on the second-generation antihistamine he or she has been prescribed? A) "I know these can be a bit expensive, but hopefully it will be worth it for me." B) "I'm really hoping that these pills will cure my allergies before summer starts." C) "I'll check with my doctor to make sure that the diet supplements I'm taking are okay to take at the same time as these pills." D) "It's handy that I don't necessarily have to take these pills at bedtime."
B
Which medication may be administered for the treatment of nausea and vomiting that has not responded to initial first-line antiemetic therapy? A) first-generation antihistamine agent: chlorpheniramine B) first-generation antihistamine agent: hydroxyzine C) second-generation antihistamine agent: loratadine D) second-generation antihistamine agent: cetirizine
B
A client is instructed to take diphenhydramine after an allergic reaction. Which statement by the client indicates successful teaching concerning the safe and effective use of diphenhydramine? A) "I will still be able to have my after-dinner drink with this medication." B) "I will eat a diet low in sodium while taking this medication." C) "I should not drive my car after taking this medication." D) "I can take this medication every 2 hours until I feel better."
C
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? A) loratadine B) promethazine C) diphenhydramine D) olopatadine
C
The nurse working in the emergency department anticipates an order of a severe allergic reaction with anaphylaxis, knowing that the drug of choice for severe allergic reactions with anaphylaxis is which of the following? A) diphenhydramine B) cimetidine C) epinephrine D) loratadine
C
Which disorder will contraindicate the administration of promethazine to a child? A) bacterial meningitis B) endocarditis C) Reye's syndrome D) hypertensive crisis
C
A client, prescribed cephalexin for an upper respiratory infection 7 days ago, develops myalgia and fever. What reaction is responsible for this symptomology? A) a new infection B) an autoimmune disease C) septicemia D) serum sickness
D
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? A) antipyretics B) antimicrobials C) antianginals D) antihistamines
D
In explaining options for antihistamine medications to a patient, second-generation H1 antagonists differ from first-generation H1 antagonists in that they do which of the following? A) cause greater central nervous system sedation B) are available only by prescription C) are less expensive D) do not cross the blood-brain barrier
D
What is the chemical mediator released in immune and inflammatory response to allergic reactions? A) norepinephrine B) mast cells C) epinephrine D) histamine
D
Which client should not be administered an antihistamine? A) a male client with Parkinson's disease B) a female client with asthma C) a male client with diabetes mellitus D) a male client with prostatic hypertrophy
D
Which second-generation H1 receptor antagonist antihistamine is formulated as a nasal spray for topical use by children aged 5 years and older? A) chlorpheniramine B) clemastine C) cyproheptadine D) azelastine
D
An elderly client is prescribed diphenhydramine for allergic response to mold. What should be the focus of the nursing assessment for the client? A) anticholinergic effects B) dysrhythmias C) increased muscle tone D) respiratory depression
A
What type of hypersensitivity reaction causes allergic rhinitis? A) type I B) type II C) type III D) type IV
A
When should a client self-medicating with cetirizine, expect the medication to reach maximum effects? A) 1 hour B) 2 to 3 hours C) 8 to 12 hours D) 12 to 24 hours
A
Which assessment finding should prompt the nurse to suspect that the resident is experiencing an anticholinergic effect of diphenhydramine? A) blurry vision B) tinnitus C) wheezing on expiration D) urticaria
A
Because of the action of antihistamines on target tissues, these drugs are effective in producing which of the following actions? SELECT ALL THAT APPLY. A) inhibiting vascular permeability B) reducing pruritus C) minimizing edema formation D) preventing histamine release
A, B, C
