Chapter 31 Prep U

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?"

A client is currently taking pseudoephedrine to help manage the nasal congestion resulting from seasonal allergies. When the client reports being extremely restless and having difficulty getting to sleep at night, what assessment question will the nurse ask to best provide interventions to minimize those effects?

"How much coffee, tea, and soda do you drink daily?"

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?"

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 can use the adult brand, but we just have to decrease the amount."

Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug?

Antidote for acetaminophen poisoning

A client is prescribed oxymetazoline. Which assessment data would indicate that the drug is effective?

Breathing pattern is regular and without difficulty.

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?

Decongestants

Before administering a mucolytic drug to a client with an upper respiratory infection, which would the nurse need to assess?

Degree of dyspnea

A 45-year-old female client is being seen in the health care provider's office for a dry, hacking cough that is keeping her up at night. The provider prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan?

Dextromethorphan works in the medulla to suppress the cough reflex.

A client presents at the clinic with a dry, nonproductive cough. The client is diagnosed with bronchitis, and it is determined that they will need help thinning sputum so that the cough can become productive. What does the nurse expect will be prescribed for the client?

Guaifenesin

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

High Fowler's

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

A female client calls the pediatrician's office for a suggestion regarding the best over-the-counter cough and cold medicine for her 6-month-old child. The pediatrician advises against the medication for what reason?

Misuse could result in overdose.

A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions?

Mucolytic

What is an adverse reaction commonly experienced by people taking nasal decongestants?

Rebound congestion

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

A male client is diagnosed with chronic bronchitis. What would the nurse expect to be one of his physical reports?

Retention of secretions

A male client presents to the health care provider's office for his annual visit. When questioned about over-the-counter medication use, he states that he uses echinacea to prevent colds. What statement is true about echinacea?

There is limited or no support for the use of echinacea to prevent or treat symptoms of the common cold.

The nursing instructor is discussing the use of nasal decongestants and shares what reason for their effectiveness?

They come into direct contact with nasal mucosa.

A client has just been admitted for an overdose of pseudoephedrine. The nurse's assessment of the client should prioritize what system?

cardiovascular

A client is hospitalized with acute bronchitis, a dry, nonproductive cough, elevated temperature, and complaints of being unable to sleep well at night due to coughing. The nurse notes diminished breath sounds in both lower lung lobes. Which medication will the nurse most anticipate the health care provider to prescribe for this client?

expectorant

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

high Fowler's position.

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)

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:

stop taking the medication and come to the clinic as ordered by the health care provider.

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

The nurse would caution clients with which disorders to avoid the use of over-the-counter pseudoephedrine? (Select all that apply.)

- Diabetes - Cardiovascular disorders - Glaucoma

A client asks, "What is the difference between antitussive medications and expectorants?" What information should the nurse's response be based upon?

Antitussives suppress coughing while expectorants loosen bronchial secretions.

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 break down the thickness of secretions.

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?

"Drink at least two liters of fluids each day."

The nurse has taught a client to self-administer a topical decongestant. What statement should the nurse follow up with further education?

"I'll squeeze the bottle to get the medication up into my sinuses."

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?

"You should come to the clinic to be evaluated. A cough that lasts that long might indicate a medical problem."

A 29-year-old client has sinusitis and has been prescribed a topical nasal decongestant. What instructions should the nurse provide?

Increase fluids to 2 L/d.

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

Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine?

ineffective airway clearance

When describing the action of decongestants, a nurse integrates knowledge of this class of drugs, identifying which mechanism?

Vasoconstriction of small blood vessels of the nasal membranes

The nursing instructor is discussing over-the-counter cold remedies. According to the instructor, these products typically combine

a decongestant, an analgesic, and an antihistamine.

A client with a respiratory tract infection is prescribed expectorants. A nurse should administer expectorants cautiously in clients with:

a persistent cough.

The nurse is discussing the use of pseudoephedrine with parents of children of various ages. What statement made by a parent demonstrates an understanding of the safe administration of a decongestant?

"Only my children who are 12 years of age or older can be given the extended-release form of pseudoephedrine."

What statement by a client who is to take an antitussive with codeine indicates that the nurse's teaching has been effective?

"This medication can cause drowsiness, so I will avoid driving after taking it."

The nurse is providing health education to an adult client who is taking an over-the-counter combination cold and cough remedy. What guidance should the nurse include to best assure medication safety?

Carefully read the label and adhere to the guidelines for use.

What home remedies are effective for mouth dryness and cough? (Select all that apply.)

- Adequate fluid intake - Humidification of the environment - Sucking on hard candy or throat lozenges

Mr. Johnson is prescribed pseudoephedrine to relieve his nasal congestion. What should the nurse include in patient and family education? Select all that apply.

- Advise him to avoid excessive and frequent use of the drug. - Advise him not to take other OTC drugs.

A group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example?

Guaifenesin

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?

inflammatory processes

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?

rebound congestion

A 76-year-old man has a history of heart disease, and has been prescribed an oral decongestant. The nurse is concerned with this prescription because of the risk for which?

serious cardiovascular effects.