Chapter 31: Drug Therapy for Nasal Congestion and Cough
A client reports having difficulty finding the over-the-counter (OTC) decongestant that the client used in the past. What assessment question should the nurse ask to help address the client's concern? "Did the medication contain pseudoephedrine?" "Have you asked the pharmacist about a substitute medication?" "Would you like your health care provider to prescribe something for congestion?" "How long has it been since you last needed to take a decongestant?"
"Did the medication contain pseudoephedrine?"
Question 16 of 20 A 25-year-old female client presents at the clinic with bronchitis. The health care provider orders guaifenesin. Which instruction should the clinic nurse offer when teaching the client about the medication? "Take an NSAID to relieve the joint aches that result from taking this medication." "Drink at least two liters of fluids each day." "Use a second method of contraception until you've completed the drug therapy." "Restrict your fluid intake to one liter each day."
"Drink at least two liters of fluids each day."
An adult client presents with a cough likely related to seasonal allergies. When a prescription for an antitussive medication is suggested, the client responds, "I took a tablespoon of honey before bed last night and it seemed to help. Why can't I just keep taking that a couple of times a day?" Which response should the nurse provide to best assure effective drug therapy for this client? "It would be best to alternate between honey and doses of the antitussive medication." "That would be all right but don't use raw honey." "The honey's effectiveness is very likely to wear off after 2-3 days." "Since the honey helps, it would be wise to continue taking it but no more than 3 tablespoons a day."
"The honey's effectiveness is very likely to wear off after 2-3 days."
What statement by a client who is to take an antitussive with codeine indicates that the nurse's teaching has been effective? "This medication may make me anxious and nervous." "I might get diarrhea, so I'll call my provider if that happens." "I will take this medication anytime I start to cough." "This medication can cause drowsiness, so I will avoid driving after taking it."
"This medication can cause drowsiness, so I will avoid driving after taking it."
Question 8 of 20 After teaching a group of parents about the use of over-the-counter cough and cold products with their children, which statement indicates the need for additional teaching? "We need to read the label carefully to see how often and how much to give." "We can use the adult brand, but we just have to decrease the amount." "We can use over-the-counter products for our 5-year-old but not for our 18-monthold." "We should use the cup that comes with the drug to measure it out."
"We can use the adult brand, but we just have to decrease the amount."Parents should use the children's, pediatric, or infant formulations of the drug. Over-the-counter cough and cold preparations should not be used in children under the age of 2 years. The parents need to read the label carefully to determine the dosage and frequency, and they need to use the device that comes with the drug to ensure a proper dosage.
What would be the nurse's best response if a client 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? "Look for dextromethorphan as an ingredient in any OTC cough preparation." "You should come to the clinic to be evaluated. A cough that lasts that long might indicate a medical problem." "The doctor could order an antihistamine, which might dry up your secretions and stop the cough." "Drink a lot of fluids and take aspirin, which should reduce the irritation in your throat."
"You should come to the clinic to be evaluated. A cough that lasts that long might indicate a medical problem." A cough that has persisted for 2 weeks could be indicative of an underlying medical condition that should be addressed before treating the cough. The patient should be asked to come in for an evaluation. Dextromethorphan could help stop the cough, but suppressing the cough might not be in the patient's best interest. Drying the mucosa with an antihistamine could aggravate the cough. Aspirin would not be indicated for relieving throat irritation.
Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug? Treatment of bronchospasm Conversion of cardiac arrhythmias Treatment of peptic ulcer disease Antidote for acetaminophen poisoning
Antidote for acetaminophen poisoning
A client asks, "What is the difference between antitussive medications and expectorants?" What information should the nurse's response be based upon? Both drug types loosen bronchial secretions for ease of removal. Antitussives suppress coughing while expectorants loosen bronchial secretions. Antitussives liquefy bronchial secretions while expectorants assist in the expectoration of those secretions. Antitussives kill cold viruses while expectorants liquefy bronchial secretions.
Antitussives suppress coughing while expectorants loosen bronchial secretions.
A client comes to the clinic with what appears to be a cold. What group of upper respiratory drugs cause local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow? Antitussives Expectorants Decongestants Mucolytics
Decongestants
A client presents at the clinic with a dry nonproductive cough. The client 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 provider will prescribe? Hydrocodone Benzonatate Dextromethorphan Guaifenesin
Guaifenesin
A group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example? Guaifenesin Benzonatate Dextromethorphan Acetylcysteine
Guaifenesin
An older adult client has reported "seeing things that aren't there" after starting to take over-the-counter dextromethorphan for a nonproductive cough associated with a cold. What assessment question will provide the most relevant information regarding the possible cause of this adverse effect? "How much dextromethorphan have you been taking each day?" "Have you been nauseated as well since taking the dextromethorphan?" "Have you been taking the dextromethorphan at bedtime?" "Is the dextromethorphan making you dizzy?"
How much dextromethorphan have you been taking each day?"
A client is encouraged to take guaifenesin to loosen the secretions due to a viral respiratory infection. What should the nurse suggest to the client to make the medication work more effectively? Dilute the liquid medication with water prior to administration Increase fluid intake Take the medication with other over-the-counter medications to enhance the effect Take the medication with food
Increase fluid intake
A client is encouraged to take guaifenesin to loosen the secretions due to a viral respiratory infection. What should the nurse suggest to the client to make the medication work more effectively? Increase fluid intake Dilute the liquid medication with water prior to administration Take the medication with food Take the medication with other over-the-counter medications to enhance the effect
Increase fluid intake
The nurse is teaching a client about the administration of nasal spray. What information is most important to include in this discussion? Overuse of nasal spray may cause rebound congestion. Finish the bottle of nasal spray to clear the infection effectively. Administer the nasal spray in a prone position. Nasal spray can be shared between family members only.
Overuse of nasal spray may cause rebound congestion.
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? Xylometazoline Pseudoephedrine Ephedrine Tetrahydrozoline
Pseudoephedrine
The nursing instructor is teaching students about the administration of nasal sprays. According to the instructor, the correct patient position for administering the sprays is closest to supine. side-lying position. high Fowler's position. semi-Fowler's position.
Rationale - high Fowler's position. The patient should be standing or sitting during administration of nasal sprays. This is closest to high Fowler's position.
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? Burning of the nares secondary to chronic use of nasal sprays Chronic nasal polyps Damage of the nasal concha Rebound nasal swelling
Rebound nasal swelling
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 Damage of the nasal concha Chronic nasal polyps Burning of the nares secondary to chronic use of nasal sprays
Rebound nasal swelling
The instructor is teaching about the use of mucolytics. The nursing student demonstrates an understanding of the action of the mucolytic drugs when stating which? They are used to relieve a nonproductive cough. They are used to depress the cough center in the medulla. They are used to break down the thickness of secretions. They are used to relieve a productive cough.
They are used to break down the thickness of secretions.
A client visits the clinic and is diagnosed with acute sinusitis. To promote sinus drainage, what medication might be ordered? Topical decongestants First-generation antihistamines Topical nasal steroid decongestants Second-generation antihistamines
Topical decongestants
When describing the action of decongestants, a nurse integrates knowledge of this class of drugs, identifying which mechanism? Anesthetizing stretch receptors in the respiratory passages Vasoconstriction of small blood vessels of the nasal membranes Selectively binding to peripheral H1 receptors Nonselectively binding to central and peripheral H1 receptors
Vasoconstriction of small blood vessels of the nasal membranes Vasoconstriction of small blood vessels of the nasal membranes is the mechanism of action for decongestants. First-generation antihistamines act to nonselectively bind to peripheral H1 receptors; the mechanism of action for second-generation antihistamines is to selectively bind to peripheral H1 receptors only; and peripherally acting antitussives anesthetize stretch receptors in the respiratory passages.
Which client has an increased risk for developing an adverse reaction if prescribed pseudoephedrine nasally? a 50-year-old female diagnosed with hypothyroidism a 20-year-old male who has a 1-pack-a-day cigarette habit a 70-year-old male being treated for bilateral cataracts a 30-year-old female being treated for hyperlipidemia
a 50-year-old female diagnosed with hypothyroidism
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.) Avoidance of use in children under age 2 Importance of reading the label for ingredients and dosage Need to follow the directions for how often to give the drug Using adult formulation with smaller doses Using household measuring devices for dosage measurements
a. Avoidance of use in children under age 2b. Importance of reading the label for ingredients and dosagec. Need to follow the directions for how often to give the drugOTC cough and cold preparations should not be used in children under the age of 4 years. Accurate dosing is essential. Following the directions is essential to prevent inadvertent overdosage. Measuring devices that come with the medication should be used to ensure accurate dosages. Parents should look for the formula for children, infants, or pediatrics.
A client reports to the nurse, "My head is stuffed up and I can't breathe through my nose." Nasal discharge is noted upon examination. The client is diagnosed with a common cold. The nurse should prepare to provide medication instructions related to what classification of medication directed at the client's nasal mucosa? decongestant expectorant antihistamine antitussant
decongestant
Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine? ineffective airway clearance ineffective breathing pattern risk for infection impaired tissue perfusion
impaired tissue perfusion
Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine? ineffective airway clearance ineffective breathing pattern risk for infection impaired tissue perfusion
ineffective airway clearance
The nurse is providing education to a client who has been diagnosed with a sinus infection. What would the nurse identify as a major cause of this disorder? impaired blood supply inflammatory processes autoimmune processes facial pain
inflammatory processes As in other parts of the respiratory tract, ciliated mucous membranes in the sinuses help move fluid and microorganisms out and into the nasal cavity. This movement becomes impaired when sinus openings are blocked by nasal swelling, and the impairment is considered a major cause of sinus infections. Another contributing factor is a lower oxygen content in the sinuses, which aids the growth of microorganisms and impairs local defense mechanisms. Autoimmune processes and impaired blood supply are not major causes. Facial pain is a symptom of sinus infection.
The nurse taking a medical history determines that the client takes a decongestant regularly for a variety of seasonal allergies. What other medication identified in the client's current medication history would constitute an immediate risk to the client's health? monoamine oxidase inhibitor (MAOI) an inhaled steroid antibiotic proton pump inhibitor (PPI)
monoamine oxidase inhibitor (MAOI)
A client reports experiencing severe nasal congestion since starting to use an over-the-counter (OTC) nasal decongestant spray a week ago. This symptomology most supports what possible medical condition? bronchitis rebound congestion a drug allergy sinusitis
rebound congestion
A 43-year-old man is taking pseudoephedrine (Sudafed) for sinusitis. He calls the clinic to report that it feels like his heart is racing and that he can "feel his heart beating fast." The nurse will instruct him to: decrease the dosage by one half. continue taking the drug because the sensations will resolve with time. lie down after each dose. stop taking the medication and come to the clinic as ordered by the health care provider.
stop taking the medication and come to the clinic as ordered by the health care provider.