Chapter 32 course point
A male client asks the nurse whether antihistamines will help him cope with the symptoms of the common cold. What is the nurse's best response?
"Antihistamines do not relieve symptoms."
A client is in the clinic for seasonal allergic rhinitis. Loratadine (Claritin) is prescribed. Which statement will the nurse include when providing education concerning this drug?
"Determine if the drug is going to make you drowsy before you drive."
A nurse is teaching a 55-year-old client about fexofenadine prescribed to treat allergic symptoms. Which client statement suggests an understanding of this teaching?
"I should avoid driving after taking this medication."
The nurse is providing instructions to a client who will be taking second-generation antihistamines at home. Which statement by the client indicates a need for further instruction?
"I will take this medication with apple juice."
The nurse is teaching a client about the potential for allergic drug reaction. What statement made by a client suggests a need for further teaching?
"If you didn't have allergies as a child, you won't develop allergies later in life."
A nursing professor has just completed her lecture regarding hypersensitivity (allergic) responses. Her lecture focused on Type III reactions. Which of the following statements made by her students will show that the students understood the material? Choose all that apply.
"It is an IgG- or IgM-mediated reaction that forms antigen-antibody complexes that kicks in inflammation in the tissue." "Serum sickness is the prototype of these reactions."
Fexofenadine (Allegra) is prescribed for a client with seasonal allergies. What should the nurse teach the client about the side effects of this medication?
"Less drowsiness occurs with this medication compared to other antihistamines."
A nursing professor teaching sophomore students conducts a lecture regarding allergic food reactions. Which of the following statements made by the students verifies the lecture was effective? Select all that apply.
"They usually are an immune response to the ingestion of a protein." "Shellfish and eggs are examples of allergens that may have a high risk for anaphylaxis."
A professor teaching pharmacology conducts a lecture regarding allergic drug reactions. Which of the following statements made by students verifies the lecture was effective? Select all that apply.
"Virtually any drug may induce an immunologic response." "Allergic drug reactions are complex and diverse and may include any of the types of hypersensitivity."
The nurse is providing education to a client regarding the use of an over-the-counter (OTC) antihistamine. Which client statement demonstrates a need for additional teaching?
"When I feel a cold coming on, I know to take an antihistamine."
A nursing professor is teaching the class regarding the use of antihistamines in patients with renal impairment. Which of the following statements made by students indicates an understanding of the lecture? Choose all that apply.
"With diphenhydramine, the dosing interval should be extended to 12 to 18 hours." "For some antihistamines, doses for initial use are approximately one half of those used for young and middle-aged adults." "Azelastine may be the drug of choice because it is metabolized in the liver."
A client receives diphenhydramine orally. The nurse would expect this drug to begin acting within which time frame?
15 to 30 minutes
A client whose daily commute includes travel on a ferry boat has been prescribed diphenhydramine. During client teaching, the nurse should instruct the client to take the medication at what time?
30 to 60 minutes before the ferry trip
When developing the teaching plan for a client receiving an antihistamine, which would the nurse include? (Select all that apply.)
Advising the client to avoid alcohol consumption Using sugarless candies or lozenges to combat dry mouth
A nurse is preparing to administer an antihistamine to a client. The nurse integrates knowledge about this class of drugs, identifying which condition or disease as a possible use to alleviate symptoms? Select all that apply.
Allergic rhinitis Parkinsonism Nausea
A nurse is assessing patients who are to be initiated with antihistamine therapy. For which of the following conditions is this therapy contraindicated? Select all that apply.
Angle-closure glaucoma Pregnancy
A client exhibiting signs and symptoms of the common cold asks the nurse if taking an antihistamine would be helpful. What is the nurse's best response?
Antihistamines are not recommended for treating a cold.
When considering possible side effects, which client should be considered for a prescription of cetirizine rather than diphenhydramine?
Any adult older than 56-years-of age.
Second-generation antihistamines were developed to remove the sedation of first generation drugs. Which of the following antihistamines is a second-generation drug?
Cetirizine
The nursing instructor is describing the four types of hypersensitivity reactions. What alternate name might the instructor use to identify type IV hypersensitivity?
Delayed hypersensitivity
A nurse is describing the action of a prescribed antihistamine to a client. The nurse is describing which medication, by explaining that the drug elicits its antihistamine effects by non-selectively binding to central and peripheral H1 receptors?
Diphenhydramine
The health care provider has prescribed medication to prevent posttransfusion reaction in a client with a history of the disorder. Which medication would the nurse anticipate being administered?
Diphenhydramine
A client has begun taking an antihistamine for the treatment of seasonal allergies. What dietary guidelines should the nurse provide to the client?
Do not drink alcohol while taking antihistamines.
A 76-year-old client has been prescribed an oral antihistamine. What adverse effect presents a priority safety concern for older adult clients?
Drowsiness
A female client is prescribed a first-generation antihistamine for her allergies. The nurse would expect her to experience what adverse effect?
Dry mouth
The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects?
Excessive salivation
Antihistamines are used frequently in the home care setting for the treatment of allergies. Which of the following is most likely to be a responsibility of the nurse caring for a patient who is taking antihistamines for this indication?
Helping the patient identify environmental allergens
Which of the following side effects is an elderly client more likely to experience during treatment with an antihistamine? Select all that apply:
Hypotension Dry mouth Sedation
Mr. Zee is prescribed an inhaled nasal steroid to relieve his symptoms associated with seasonal allergies. What is true about inhaled nasal steroids?
Inhaled nasal steroids are more effective than oral medications in treating the global symptoms associated with allergies.
Which statement accurately describes an aspect of serum sickness?
Is a delayed hypersensitivity reaction.
The nurse is caring for a client who has been diagnosed with allergic rhinitis and takes clemastine daily. What should the nurse teach the client about the action of the medication?
It blocks the effects of histamine.
A group of students are reviewing information about antihistamines. The students demonstrate understanding of the information when they identify which agent as a second generation antihistamine?
Loratadine
A patient with vasomotor rhinitis has been prescribed an antihistamine. The patient is eager to know whether the prescribed antihistamine may cause excessive sedation. Which of the following antihistamines has very little sedative effect?
Loratadine
A client reports increased sedation after the initiation of chlorpheniramine to treat her allergies. Which antihistamines could the nurse recommend to the client to treat her allergy symptoms that would result in less sedation? (Select all that apply.)
Loratadine (Claritin) Cetirizine (Zyrtec)
The nurse is aware that clients who use OTC fexofenadine would use which class of antibacterial that would cause an increased plasma concentration of the fexofenadine?
Macrolides
A nurse is reviewing the medical record of a client who is prescribed an antihistamine. The nurse would administer the drug cautiously if which condition was noted? Select all that apply.
Narrow-angle glaucoma Hyperthyroidism Hypertension
Pseudoephedrine (Sudafed) is prescribed for a client suffering from nasal and sinus congestion. What is the most important assessment the nurse should complete before the client leaves the clinic to purchase the medication?
Obtain the clients blood pressure
Some antihistamines can produce significant sedation. Which drug is most likely to cause this adverse effect?
Promethazine
An older adult client is administered dimenhydrinate. Which is the priority nursing intervention for this client?
Protect from injury.
The nurse is teaching a group of clients with allergic rhinitis (hay fever) about medication use. What would be the most essential information to give these clients about preventing possible drug interactions?
Read drug labels before taking OTC medications.
Combining first-generation antihistamines with sedating agents can result in what adverse effect?
Respiratory depression
What type of antihistamine is typically preferred for older adults?
Second-generation
A 15-year-old patient is prescribed an antihistamine for allergic rhinitis. However, antihistamines used to treat allergic reactions may themselves cause allergy. The nurse needs to educate the patient to be aware of symptoms suggesting allergy. Which of the following is an allergic reaction to antihistamines?
Skin rash and urticaria
A 62-year-old client has been prescribed an antihistamine to alleviate vasomotor rhinitis. The client reports gastric irritation after taking the tablet. Which instructions should the nurse provide to help alleviate the client's condition?
Take the tablet with food
A 56-year-old client is prescribed fexofenadine for relief of symptoms associated with allergic rhinitis. Which finding in the client's medical record would be of concern?
The client has increased BUN and creatinine levels.
The nurse is providing medication education to the client who has been prescribed fexofenadine. What information will the nurse provide if the client expresses concern about medication induced drowsiness?
The medication does not cross the blood-brain barrier
Second-generation H1 antagonists cause less CNS depression because they are selective for peripheral H1 receptors and because of which other property?
They do not cross the blood-brain barrier.
What is one of the benefits related to second generation antihistamine administration in older adults?
They do not impair thinking.
What causes the inflammation of nasal mucosa that is seen in allergic rhinitis?
Type I hypersensitivity reaction to Inhaled allergens
Which client is most likely to benefit from the administration of a nasal steroid?
a client who has chronic allergic rhinitis (hay fever)
What hospital procedure has the greatest potential to cause an anaphylactoid reaction?
administration of contrast media for diagnostic tests
Which systemic response of anaphylaxis may be successfully treated with antihistamine therapy? Select all that apply.
appearance of hives on the trunk and neck development of an itchy skin rash watery nasal discharge
The nurse is caring for an adult client with a new prescription for cetirizine. To reduce the risk for drug-drug interactions, the nurse should ask the client about current therapy if there is a history of what disorder?
asthma
A client diagnosed with allergic rhinitis has expressed a lack of interest in treating the disorder. When providing client teaching, what should the nurse identify as potential effects of avoiding treatment? Select all that apply.
chronic fatigue insomnia sinusitis asthma
The nurse reviews the client's medical history before providing medications. Which antihistamine would the nurse question before providing a dose to the client?
diphenhydramine
What medication should be prescribed to minimize the risk associated with a blood transfusion for a client with a history of a previous transfusion reaction?
diphenhydramine
A 20-year-old woman calls the clinic at 5 PM and reports to the nurse that she forgot to take her morning dose of fexofenadine (Allegra). She usually takes her evening dose at 8 PM. She wants to know what she should do. The nurse will instruct her to
forget about the morning dose and take the evening dose.
The health care provider has ordered promethazine (Phenergan) for a client who is having a severe allergic reaction. The nurse is aware that this medication is also used to treat what condition?
nausea and vomiting
Antihistamines are not routinely used in the critically ill client population. Diphenhydramine, however, may be administered to a critically ill client for which reason?
prior to a blood transfusion.
When describing the effects of second-generation antihistamines, which would the nurse address as being decreased?
sedation
The nursing instructor is explaining the four types of allergic reaction to the nursing students. The instructor explains that allergic rhinitis is a
type I hypersensitivity reaction.
