Ch 35, 36 - respiratory
The primary health care provider prescribed ephedrine HCl (Primatene) to a patient with nasal congestion. Which instruction should the nurse provide to the patient to prevent restlessness and palpitations? "Avoid coffee." "Avoid alcohol." "Avoid grapefruit juice." "Avoid drug intake 30 minutes prior to meals."
"Avoid coffee."
The registered nurse is observing a nursing student while caring for a patient receiving diphenhydramine (Benadryl) therapy. Which instruction given by the nursing student requires correction? "Use sugarless candy or gum for mouth dryness." "Avoid driving a motor vehicle until drug stabilization occurs." "Notify the primary health care provider in case of confusion or hypotension." "Avoid drinking central nervous system (CNS) stimulants, such as coffee and tea."
"Avoid drinking central nervous system (CNS) stimulants, such as coffee and tea."
A nursing student is learning about the pharmacokinetics of the first-generation antihistamine diphenhydramine (Benadryl) and the antitussive dextromethorphan (Benylin DM). Which statement made by the nursing student indicates effective learning? "Both diphenhydramine and dextromethorphan are excreted in a similar manner." "Both diphenhydramine and dextromethorphan are known to be highly protein-bound." "Diphenhydramine has a half-life of 11 hours while dextromethorphan has a half-life of 5 hours." "Diphenhydramine has multiple routes of administration while dextromethorphan is always given intramuscularly."
"Both diphenhydramine and dextromethorphan are excreted in a similar manner." Both diphenhydramine (Benadryl) and dextromethorphan (Benylin DM) are metabolized by the liver and excreted as metabolites in the urine. Diphenhydramine (Benadryl) is known to be highly protein-bound (i.e., around 98%), but the protein-binding percentage of dextromethorphan (Benylin DM) is unknown. Diphenhydramine (Benadryl) has a half-life of 2 to 7 hours on average, whereas dextromethorphan (Benylin DM) has a half-life of 11 hours. Diphenhydramine (Benadryl) does have multiple routes of administration; it can be given orally, intramuscularly, or intravenously. However, dextromethorphan (Benylin DM) is administered orally; it is available in numerous cold and cough remedy preparations in syrup or liquid form, or as chewable capsules and lozenges.
The nurse is caring for a patient who is taking a first-generation antihistamine. What is the most important information for the nurse to teach the patient? "Do not drive after taking this medication." "Take this medication on an empty stomach." "Do not take this medication for more than 2 days." "Make sure you drink a lot of liquids while on this medication."
"Do not drive after taking this medication."
The nurse is caring for a patient who is taking a traditional antihistamine. What is the most important information for the nurse to teach the patient? "Do not drive after taking this medication." "Take this medication on an empty stomach." "Do not take this medication for more than 2 days." "Make sure you drink a lot of liquids while on this medication."
"Do not drive after taking this medication."
A patient complains of worsening nasal congestion despite the use of oxymetazoline nasal spray every 2 hours. What is the nurse's most appropriate response? "Oxymetazoline is not an effective nasal decongestant." "Overuse of nasal decongestants results in rebound congestion." "You are probably displaying an unexpected reaction to oxymetazoline." "Oxymetazoline should be administered every hour for severe congestion."
"Overuse of nasal decongestants results in rebound congestion."
A patient is prescribed dextromethorphan (Robitussin) for treatment of cough. What instruction will the nurse give to the patient for safe administration of the drug? "Use a humidifier while sleeping." "Elevate your bed while sleeping." "Increase your fluid intake to 3000 mL per day." "Restrict activities that require mental alertness."
"Restrict activities that require mental alertness." Dextromethorphan (Robitussin) is a nonopioid antitussive drug that may also cause sedation, drowsiness, or dizziness. The nurse should advise the patient to avoid activities that require mental alertness. It helps prevent injury to the patient. Use of a humidifier helps maintain hydration levels but does not reduce the risk of injury to the patient. Elevating one's head while sleeping helps with lung expansion and promotes breathing. Fluid intake should be increased when decongestants are administered because fluids help liquefy secretions and make it easier to cough up secretions.
A patient is prescribed ipratropium (Atrovent) and cromolyn sodium. What will the nurse teach the patient? "Do not take these medications within 4 hours of each other." "Take the ipratropium (Atrovent) at least 5 minutes before the cromolyn." "Administer both medications together in a metered-dose inhaler." "Take the ipratropium (Atrovent) only in the mornings."
"Take the ipratropium (Atrovent) at least 5 minutes before the cromolyn."
A patient will begin taking diphenhydramine (Benadryl) to treat motion sickness. What instruction will the nurse give to the patient to prevent gastrointestinal (GI) upset? "Take the medication with food." "Use a humidifier while sleeping." "Increase fluid intake to up to 3000 mL." "Sleep with your head in an elevated position."
"Take the medication with food."
A patient presents with acute inflammation of the mucous membranes of the nose. Which statements does the nurse know to be true for the disease that the patient is suffering from? "The patient's cat is likely to be responsible for the disease." "The patient can be administered a second-generation antihistamine." "The patient most likely acquired the disease from the viral droplets released by sneezing." "The patient will have a tenacious, mucoid, and yellow-green nasal discharge only if no secondary infection occurs." "The patient's symptoms can be managed by sympathomimetic amines that cause vasoconstriction of the capillaries."
"The patient can be administered a second-generation antihistamine." "The patient's symptoms can be managed by sympathomimetic amines that cause vasoconstriction of the capillaries."
A patient is prescribed an antitussive medication. What is the most important instruction for the nurse to include in the patient teaching? "Watch for diarrhea and abdominal cramping." "This medication may cause tremors and anxiety." "Headache and hypertension are common side effects." "This medication may cause drowsiness and dizziness."
"This medication may cause drowsiness and dizziness."
The nurse is teaching the patient on the use of beclomethasone diproprionate (Beconase). Which statement by the patient indicates an understanding of the teaching? "I need to take this medication only when my symptoms get bad." "I will need to taper off the medication to prevent acute adrenal crisis." "I will need to monitor my blood sugar more closely because it may increase." "This medication will help prevent the inflammatory response of my allergies."
"This medication will help prevent the inflammatory response of my allergies."
The registered nurse asks a nursing student to provide care instructions to the family members of a child who is on diphenhydramine (Benadryl) therapy. Which statement by the nursing student shows effective learning? "Your child may feel faint or dizzy." "Your child may experience insomnia." "Your child may experience painful urination." "Your child may experience nightmares and nervousness"
"Your child may experience nightmares and nervousness" Diphenhydramine (Benadryl) specifically causes nightmares, irritability, and nervousness in children. An older adult who takes this drug may experience a feeling of faintness or dizziness. Insomnia may occur if a drug containing decongestant is taken before or at bedtime. An older adult taking diphenhydramine (Benadryl) may develop urinary retention.
What is a normal theophylline level? 5 to 10 mg/mL 5 to 15 mcg/mL 5 to 15 mg/mL 5 to 10 mcg/mL
5 to 15 mcg/mL
A patient presents to the emergency room with acute bronchospasms caused by anaphylaxis. What classification of medication does the nurse anticipate administering? Alpha 1-adrenergic agonist A nonselective sympathomimetic Beta 2-adrenergic agonist Cyclic adenosine monophosphate (cAMP)
A nonselective sympathomimetic
To which patient can the nurse safely administer an order for guaifenesin 200 mg and codeine 9 mg two capsules every four hours by mouth as needed? A patient with acute asthma A patient with an allergy to hydrocodone A patient newly diagnosed with pneumonia A patient who has experienced a recent head injury
A patient newly diagnosed with pneumonia It is safe to administer the order to the patient newly diagnosed with pneumonia. The guaifenesin is an expectorant that will loosen bronchial excretions so coughing can eliminate them, and the codeine will provide relief from any pain. Codeine can cause respiratory problems for a patient with asthma. Hydrocodone is a synthetic derivative of codeine, so this order is unsafe for the patient with the allergy. Codeine administered to a patient who has experienced a recent head injury can cause alteration in the neurologic status and may mask any significant neurologic changes.
A nurse is studying the contraindications for administering diphenhydramine (Benadryl) and dextromethorphan hydromide (Benylin DM) syrup to patients. Which patients are known to be unsuitable candidates for treatment with both these medications? A patient who is an alcoholic A patient who is a 2-day-old infant A patient with narrow-angle glaucoma A patient suffering from an acute asthma attack A patient suffering from a chronic productive cough
A patient who is an alcoholic A patient who is a 2-day-old infant
Which patient is at risk of developing complications if diphenhydramine (Benadryl) is administered? A patient with hypersensitivity A patient with narrow-angle glaucoma A patient with chronic productive cough A patient with chronic obstructive pulmonary disease
A patient with narrow-angle glaucoma
The patient tells the nurse that she has a cold, is coughing, and feels like she has fluid in her lungs. What action will the nurse anticipate performing next? Administer guaifenesin Administer dextromethorphan Administer fluticasone (Flonase) Encourage the patient to drink fluids hourly
Administer guaifenesin
A patient is prescribed theophylline (Theobid) for the treatment of chronic bronchitis. What instruction does the nurse give to the patient for safe administration of theophylline (Theobid)? Avoid intake of a high-protein diet. Avoid consumption of citrus fruit. Increase fluid intake up to 3 liters per day. Increase intake of low-carbohydrate food.
Avoid intake of a high-protein diet.
The nurse is caring for a patient with bronchospasm associated with chronic obstructive pulmonary disorder with a prescription for tiotropium (Spiriva). What is the best nursing intervention for the safe use of the medication? Advising the patient to avoid chocolates Advising the patient to increase fluid intake Advising the patient to use the drug in the evening Advising the patient to wash the HandiHaler with warm water
Advising the patient to wash the HandiHaler with warm water
A patient is prescribed diphenhydramine (Benadryl) for the treatment of an allergic disorder. After reviewing the patient's history, the nurse finds that the patient drinks alcohol. Why will the nurse instruct the patient to stop alcohol consumption? Alcohol increases central nervous system depression. Alcohol diminishes the action of diphenhydramine (Benadryl). Alcohol increases diphenhydramine (Benadryl) levels in the body. Alcohol and diphenhydramine (Benadryl) interaction produces skin rashes.
Alcohol increases central nervous system depression.
Which over-the-counter drug categories are available for the treatment of cough? Analgesics Antitussives Expectorants Antimicrobials Antihistamines
Antitussives Expectorants Antihistamines
Which drug is an antihistamine? Budesonide Baclofen Benadryl Benazepril
Benadryl
After administering formoterol to a patient with chronic obstructive pulmonary disease (COPD), which physiologic effect on the patient does the nurse anticipate? Bronchodilation Suppressed release of histamine Decreased bronchiole inflammation Loosened mucus in the airways
Bronchodilation Formoterol will cause bronchodilation in the patient to treat bronchospasms associated with COPD. Leukotriene modifiers suppress the release of histamine and reduce inflammation. Expectorants loosen the mucus from the airway.
Which drugs are classified as glucocorticoids? Azelastine (Astelin) Budesonide (Pulmicort) Naphazoline HCl (Privine) Triamcinolone (Nasacort AQ) Benzonatate (Tessalon Perles)
Budesonide (Pulmicort) Triamcinolone (Nasacort AQ)
The health care provider indicates that the patient will be ordered an opioid antitussive. Which medication does the nurse anticipate the provider will order? Codeine Benzonatate Levocetirizine Promethazine with dextromethorphan
Codeine
A patient diagnosed with rhinitis receives a 30-day prescription for pseudoephedrine by mouth (PO) 80 mg every four to six hours for a maximum of 320 mg/day. Prior to discharging the patient, what is the nurse's next action? Contact the prescriber. Review the patient's medical history. Reinforce the avoidance of alcohol use while taking the medication. Instruct the patient about the signs and symptoms of rebound nasal congestion.
Contact the prescriber. Prior to discharging the patient from the clinic, the nurse's next action is to contact the prescriber. The 30-day prescription for pseudoephedrine PO 80 mg every four to six hours exceeds the daily recommended dosage of 240 mg/day and the national regulatory limit of 9 g within 30 days. The patient's medical history should be reviewed prior to the medication being prescribed. It is recommended that the patient avoid large amounts of caffeine because it can increase restlessness and palpitations caused by decongestants such as pseudoephedrine. Rebound nasal congestion occurs when pseudoephedrine is administered via a nasal spray, not by mouth.
The nurse is caring for a patient with a theophylline level of 14 mcg/mL. What is the priority nursing intervention? Increase the IV drip rate. Monitor the patient for toxicity. Continue to assess the patient's oxygenation. Stop the IV for an hour then restart at lower rate.
Continue to assess the patient's oxygenation.
Which drug suppresses the release of histamine from mast cells? Albuterol (Proventil) Acetylcysteine (Mucomyst) Dexamethasone (Decadron) Cromolyn sodium (NasalCrom)
Cromolyn sodium (NasalCrom)
Which medication is the shortest-acting antihistamine for the treatment of allergic rhinitis? Diphenhydramine (Benadryl) Dexchlorpheniramine maleate Cyproheptadine HCl (Periactin) Chlorpheniramine maleate (Chlor-Trimeton)
Cyproheptadine HCl (Periactin) Cyproheptadine HCl (Periactin) is the shortest acting of these drugs. The plasma half-life (t 1/2) of cyproheptadine HCl (Periactin) is 1 to 4 hours. Diphenhydramine (Benadryl) has a t 1/2 of 4 to 6 hours. The time required for the amount of dexchlorpheniramine maleate to fall to half of its initial value in plasma is 20 to 24 hours. The t 1/2 of chlorpheniramine maleate (Chlor-Trimeton) is 10 to 24 hours.
Which antihistamine drug has the strongest side effect of drowsiness? Cetirizine (Zyrtec) Loratadine (Claritin) Fexofenadine (Allegra) Diphenhydramine (Benadryl)
Diphenhydramine (Benadryl)
Which drug will the primary health care provider prescribe for a patient who has nighttime insomnia and motion sickness? Cetirizine (Zyrtec) Loratadine (Claritin) Fexofenadine (Allegra) Diphenhydramine (Benadryl)
Diphenhydramine (Benadryl)
A patient with motion sickness is prescribed diphenhydramine (Benadryl). Which side effect will the nurse watch for in the patient? Pruritus Headache Dry mouth Lightheadedness
Dry mouth
Which side effect of a histamine (H 1) antagonist is used therapeutically for patients with allergic rhinitis? Dryness Drowsiness Palpitations Constipation
Dryness H 1 antagonists exert anticholinergic effects, including constipation, dry mouth, and blurred vision. The drugs' capacity for drying the mucous membranes makes them useful in treating upper respiratory infections and allergic rhinitis. Drowsiness, palpitations, and constipation are adverse effects of H 1, which should be reported immediately to the primary health care provider.
A nurse is caring for a patient with a common cold. While assessing the patient, the nurse suspects a viral infection. Which manifestation did the nurse notice in the patient? Nasal congestion Elevated body temperature Increased mucosal secretion Yellow-green nasal discharge
Elevated body temperature Viral infection associated with a cold may be indicated if the body temperature is elevated (99° F-101° F). Nasal congestion is a common manifestation associated with a cold. It does not indicate a viral infection. Mucosal secretion may be increased in rhinitis or cold. However, it does not indicate that the infection is viral. Discoloration of the nasal discharge indicates the formation of by-products of white blood cells and cellular debris during a fight against a bacterial infection. Therefore yellow-green nasal charge indicates a bacterial infection.
Which chronic obstructive pulmonary disorder inhibits proteolytic enzymes that destroy alveoli? Asthma Emphysema Bronchiectasis Chronic bronchitis
Emphysema
A patient reports cold, watery nasal discharge, sore throat, cough, and fever. The nurse suspects viral pharyngitis after receiving negative throat culture reports. Which regimen would ensure safe and effective care of the patient? Decreasing fluid uptake Prescribing an antibiotic Encouraging the use of lozenges Encouraging the use of saline gargles Administering acetaminophen (Tylenol)
Encouraging the use of lozenges Encouraging the use of saline gargles Administering acetaminophen (Tylenol) Acetaminophen (Tylenol) may be prescribed as a fever reducer. Lozenges are usually suggested for clients with acute pharyngitis because they help relieve sore throat. Gargling with warm salt water several times a day may also provide relief from sore throat. Because viral infection is suspected, an antibiotic will be ineffective. Increased fluid uptake acts as a supportive measure in patients with pharyngitis.
While assessing a patient with asthma, the nurse finds that the patient is hypotensive. Which drug does the nurse expect the primary health care provider to prescribe? Indacaterol (Arcapta) Levalbuterol (Xopenex HFA) Terbutaline sulfate (Brethine) Ephedrine sulphate (Primatene)
Ephedrine sulphate (Primatene)
A patient presents with allergic rhinitis. While assessing the patient, the nurse finds that the patient operates machinery in a car manufacturing plant and will not be able to take days off from work during treatment. The nurse also learns that the patient suffers from hypertension. Which nasal medication is the nurse most likely to find in the patient's prescription? Azelastine (Astelin) Levocetirizine (Xyzal) Fexofenadine (Allegra) Naphazoline HCl (Privine)
Fexofenadine (Allegra) Fexofenadine (Allegra) is a second-generation antihistamine with little or no sedative effect. Hence, a patient taking this medication can still operate machinery at work. Azelastine (Astelin) is also a second-generation antihistamine used for allergic rhinitis, but it may cause mild sedation and is not recommended for the patient in this scenario. Levocetirizine (Xyzal) is a first-generation antihistamine that can be used for the treatment of allergic rhinitis. However, its common side effects include drowsiness, fatigue, and weakness. Thus it is not an appropriate medication in this scenario. Naphazoline HCl (Privine) is a systemic decongestant. Although it can be used for allergic rhinitis, being an alpha-adrenergic agonist, it can increase the blood pressure. Hence, it should be used with extreme caution in patients with hypertension.
A 10-year-old patient is diagnosed with asthma. What medication does the nurse anticipate will be initiated? Montelukast Olodaterol Fluticasone Omalizumab
Fluticasone
The primary health care provider prescribes diphenhydramine (Benadryl) to a patient with allergic rhinitis and itching. Which parameters should the nurse monitor for safe and effective care of the patient? . Thyroxin level Granulocyte count Hemoglobin count Blood glucose level Blood platelet count
Granulocyte count Hemoglobin count Blood platelet count Diphenhydramine (Benadryl) is associated with the risk of agranulocytosis. Therefore the patient's granulocyte count should be monitored. The drug may also cause hemolytic anemia. Therefore a hemoglobin count test should be performed. Blood platelet count should be monitored because the drug is associated with the risk of thrombocytopenia. Thyroxin level should be monitored when the client is taking alpha-adrenergic drugs, because these drugs may cause hyperthyroidism. Blood glucose levels may rise with the use of sympathomimetic amines
Which drug eliminates coughing by loosening bronchial secretions? Triprolidine (Zymine) Fexofenadine (Allegra) Guaifenesin (Mucinex) Tetrahydrozoline (Tyzine)
Guaifenesin (Mucinex)
Which adverse drug reaction is associated with high doses of dextromethorphan hydrobromide (Benylin DM)? Hallucination Agranulocytosis Hemolytic anemia Thrombocytopenia
Hallucination
What adverse effects will the nurse monitor in a patient who is receiving tiotropium (Spiriva)? Skeletal pain Hyperglycemia Slow heart rate Heart palpitations Dry mouth or throat
Heart palpitations Dry mouth or throat
A patient with a history of narrow-angle glaucoma suffers from acute bronchospasm. Which drug does the nurse expect to be excluded from the prescription? Acetylcysteine (Mucomyst) Dexamethasone (Decadron) Ephedrine sulphate (Primatene) Ipratropium bromide (Atrovent HFA)
Ipratropium bromide (Atrovent HFA)
What is true about acute pharyngitis? It requires antibiotic treatment. It may be bacterial or viral in origin. It is rarely accompanied by a fever. It is not caused by alpha-hemolytic Streptococci.
It may be bacterial or viral in origin. Acute pharyngitis may be bacterial or viral in origin. It is only treated with antibiotics if it is determined to be bacterial. Viruses cannot be treated with antibiotics. Fever is a typical symptom of acute pharyngitis. Acute pharyngitis is frequently caused by alpha-hemolytic Streptococci.
What should the nurse be aware of prior to administering dextromethorphan hydrobromide? It may be given with guaifenesin. It is a sympathomimetic drug. It may cause cholinergic side effects. It cannot be used with beta-adrenergic drugs.
It may be given with guaifenesin.
What will the nurse expect to find that would indicate a therapeutic effect of acetylcysteine (Mucomyst)? Decreased cough reflex Decreased nasal secretions Liquefying and loosening of bronchial secretions Relief of bronchospasms
Liquefying and loosening of bronchial secretions
The nurse is caring for a patient who has been using over-the-counter (OTC) cold remedies to treat symptoms of rhinitis. What must the nurse remember? The patient will experience cholinergic symptoms. Many OTC cold remedies contain a first-generation antihistamine. Many OTC cold remedies contain a second-generation antihistamine. OTC cold remedies contain antihistamines with an approximate half life of 22 hours.
Many OTC cold remedies contain a first-generation antihistamine.
A patient has taken metaproterenol (Alupent). What is the nurse's priority action? Monitoring for heart rate 100 beats/min Telling the patient not to drive for 2 hours Monitoring for sedation Assessing for decreased blood glucose levels
Monitoring for heart rate 100 beats/min
The patient is taking a nonselective adrenergic agonist bronchodilator and has a history of coronary artery disease. What is a priority nursing intervention? Monitoring patient for potential chest pain Monitoring blood pressure continuously Assessing daily for hyperkalemia Assessing 12-lead ECG each shift
Monitoring patient for potential chest pain
Which drug is primarily preferred for the management of allergic rhinitis that includes hay fever and acute coryza? Phenylpropanolamine Benzonatate (Tessalon Perles) Phenylephrine HCl (Neo-Synephrine Nasal) Dextromethorphan hydrobromide (Robitussin)
Phenylephrine HCl (Neo-Synephrine Nasal)
Which disorder affects the thoracic muscular wall? Scoliosis Emphysema Bronchiectasis Myasthenia gravis
Myasthenia gravis Myasthenia gravis affects the thoracic muscular wall and may be a cause of restrictive lung disease. Scoliosis is a thoracic deformity that may cause restrictive lung disease. Emphysema affects the alveolar walls, and in bronchiectasis, the bronchi and bronchioles are dilated as a result of infection and inflammation.
Which symptom of allergic rhinitis is treated with fluticasone (Flonase)? Fluid retention Bronchospasm Nasal congestion Increased blood pressure
Nasal congestion
A patient with rhinitis is taking phenylephrine HCl (Neo-Synephrine Nasal). Which parameters should the nurse monitor to ensure safe use of the medication? Nausea Headaches Urine output Blood pressure Hemoglobin count
Nausea Headaches Blood pressure Phenylephrine HCl (Neo-Synephrine Nasal) is a nasal decongestant prescribed for the treatment of rhinitis. It can cause headache and transient hypertension; therefore the nurse should monitor for headaches and blood pressure. This drug may cause nausea. Diphenhydramine (Benadryl) may cause urinary dysfunction. Therefore urine output is monitored in clients taking diphenhydramine (Benadryl), not phenylephrine HCl. Hemoglobin count is monitored in patients taking diphenhydramine due to risk of agranulocytosis.
An adult patient is prescribed azelastine for allergic rhinitis. What medication administration instruction will the nurse give the patient? Two to three sprays in each nostril every 12 hours, max six sprays/nostril/day One spray in each nostril every 12 hours, max two sprays/nostril/day One to two spray in each nostril every 12 hours, max four sprays/nostril/day Two sprays in each nostril every 12 hours, max four sprays/nostril/day
One to two spray in each nostril every 12 hours, max four sprays/nostril/day
A patient who has bronchospasms associated with chronic obstructive pulmonary disease is being treated with tiotropium (Spiriva). Which side effects should the nurse anticipate after drug administration? Tremors Oral ulcers Palpitations Nervousness Myalgia
Oral ulcers Myalgia
A nurse assesses four different patients with common colds. Which patient would the nurse anticipate to be prescribed an antibiotic? Patient with watery nasal discharge and sneezing Patient with watery eyes and runny or stuffy nose Patient with itchy throat and watery nasal discharge Patient with tenacious yellow nasal discharge and nasal congestion
Patient with tenacious yellow nasal discharge and nasal congestion A bacterial infection secondary to a cold causes discoloration of the nasal discharge. White blood cells and cellular debris are by-products of the fight against bacterial infection, and they discolor the nasal secretions. Therefore the patient with tenacious yellow nasal discharge should be treated with an antibiotic. The patient with watery nasal discharge and sneezing has common cold symptoms and does not require treatment with an antibiotic. Likewise, watery eyes and runny or stuffy nose do not indicate a bacterial infection. Itchy throat and watery nasal discharge commonly occur with colds and are not associated with bacterial infection.
Which disorders are associated with restrictive pulmonary disease? Scoliosis Emphysema Pneumonitis Bronchiectasis Chronic bronchitis
Scoliosis Pneumonitis
The primary health care provider prescribed oxymetazoline HCl (Afrin) to a patient with allergic rhinitis. Which activity of the patient results in rebound congestion? Taking the drug before bedtime Taking the drug along with coffee Drinking grapefruit juice with the drug Taking the drug for more than 7 days
Taking the drug for more than 7 days Drug overuse leads to rebound congestion. In order to prevent it, oxymetazoline HCl (Afrin) use should be limited to 3 days. Insomnia may occur if the cold regimen contains a decongestant. Therefore it should not be taken before or at bedtime. Excess intake of tea or coffee along with decongestants should be avoided to minimize the risk of restlessness and palpitations. Grapefruit juice should not be taken along with dextromethorphan hydrobromide (Robitussin), because this may lead to toxicity.
A patient who presents with cough and difficulty breathing is prescribed decongestants and antitussives. Which assessment findings in the follow-up visit will the nurse immediately report to the primary health care provider? Temperature of 100.8° F Change in color of the sputum Increased expectoration of mucus Clear breath sounds on auscultation Respiratory rate of 30 breaths per minute
Temperature of 100.8° F Change in color of the sputum Respiratory rate of 30 breaths per minute
A nurse caring for an adult patient receives an order for intravenous (IV) diphenhydramine 50 mg for pruritus and urticaria. Based on the nurse's understanding of the pharmacodynamics, what information can be given to the patient prior to administering the drug? The drug has an immediate onset. The drug's onset is 30 minutes to one hour. The drug's onset is 15 to 30 minutes. The drug's onset is 1 to 4 hours.
The drug has an immediate onset.
A patient who reports nasal congestion is prescribed oxymetazoline hydrochloride (Afrin) 2 drops in each nostril, twice daily, for 5 days. The patient reports increased nasal congestion after 10 days. On assessment the nurse learns that the patient had increased the drug frequency to every 6 hours for 10 days. What will the nurse interpret from this information? The patient has developed an allergic reaction. The patient has developed rebound congestion. The patient has developed paradoxical reaction. The patient has experienced a side effect of the drug.
The patient has developed rebound congestion.
The nurse is caring for a patient who has been prescribed fluticasone propionate and vilanterol (Breo Ellipta). What does the nurse conclude from the patient's condition after looking at the prescription? The patient is suffering from acute asthmatic attacks. The patient's liver enzymes should be monitored closely. The patient is on long-term maintenance therapy for bronchitis or emphysema. The patient is likely to suffer from diarrhea and weight loss as drug side effects.
The patient is on long-term maintenance therapy for bronchitis or emphysema.
A patient is prescribed cromolyn sodium metered dose inhaler (MDI), two inhalations 800 mcg/spray every six hours for allergic rhinitis. What should the nurse include in the patient teaching? There is a risk for oral fungal infections. The patient's electrolytes will be monitored. The patient should not discontinue the drug abruptly. Overuse may result in a tolerance to the drug.
The patient should not discontinue the drug abruptly.
A patient using metaproterenol sulfate asks the nurse, "I have been using this metered dose inhaler (MDI) for years, why can't I just take my asthma medicine by mouth?" What information is most appropriate for the nurse to include in his or her answer? The medication is not available in pill or liquid form. The drug dosage can be reduced when taking it by mouth. There are fewer medication side effects with the use of an inhaler. Using the MDI delivers a concentrated dose of medication with greater side effects.
There are fewer medication side effects with the use of an inhaler.
Which statements are true about antihistamines? They may lead to hallucinations. They may be used to treat allergic rhinitis. They are effective in treating anaphylaxis. They are rapidly absorbed within 15 minutes. They suppress the cough reflex in the medulla.
They may be used to treat allergic rhinitis They are rapidly absorbed within 15 minutes. Antihistamines may be prescribed for allergic rhinitis to relieve symptoms such as itching, sneezing, and runny nose. Most antihistamines are rapidly absorbed within 15 minutes. Hallucinations are not a common side effect of antihistamines. Antitussives such as dextromethorphan hydrobromide (Robitussin) are associated with the side effect of hallucinations. Antihistamines are not potent enough to treat anaphylactic reactions. The cough reflex in the medulla is suppressed with the use of antitussives; these are not useful in emergency situations.
Which drugs are intranasal glucocorticoids? Triamcinolone Loratadine Flunisolide Mometasone Benzonatate
Triamcinolone Flunisolide Mometasone
Which adverse drug effect is the nurse alert for in an older adult male patient taking diphenhydramine (Benadryl)? Insomnia Hay fever Hypertension Urinary retention
Urinary retention The most common adverse effects with diphenhydramine include sedation and antimuscarinic effects, including dry mouth, urinary retention, and constipation. Hay fever is a symptom of allergic rhinitis and not a side effect of diphenhydramine. Insomnia is an adverse effect of adrenergic drugs. Hypertension is a side effect of excessive dosages of topically applied adrenergic nasal decongestant.
A patient with allergic rhinitis has been prescribed a combination of fexofenadine (Allegra) and pseudoephedrine (Sudafed). Which symptoms may be managed through this combination therapy? Pruritus Urticaria Rhinitis Conjunctivitis Allergic rhinitis
Urticaria Rhinitis Allergic rhinitis Rhinitis, urticarial, and allergic rhinitis may be treated through the combination of fexofenadine (Allegra) and pseudoephedrine (Sudafed). Cyproheptadine HCl (Periactin) may be used to treat pruritus and conjunctivitis.
Which condition is characterized by enlargement of air spaces due to the destruction of the alveolar walls? Rhinitis Emphysema Bronchial asthma Chronic bronchitis
Which condition is characterized by enlargement of air spaces due to the destruction of the alveolar walls? Rhinitis Emphysema Bronchial asthma Chronic bronchitis
A patient with a history of asthma is brought to the clinic with acute dyspnea, wheezing, hypercapnia, and hypoxemia. Which type of medication will be administered first to this patient? β 2-Agonists Glucocorticoids Anticholinergics Leukotriene modifiers
β 2-Agonists This patient is experiencing an acute obstructive respiratory attack, which may be a result of asthma, bronchitis, or emphysema. The first drug that should be administered is a β 2-agonist, and it should be delivered by way of inhalation. β 2-Agonists are effective in the relief of acute bronchospasm because they act quickly. Glucocorticoids may be administered in an acute attack but only after the β 2-agonists have dilated the bronchioles; however, glucocorticoids are not indicated for rescue therapy. Anticholinergics and leukotriene modifiers are indicated in the maintenance of obstructive respiratory disease.
