chapter 32 pharm

A client receives diphenhydramine orally. The nurse would expect this drug to begin acting within which time frame?

15-30 minutes

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.

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.

Hypertension Narrow-angle glaucoma Hyperthyroidism

Type II allergic responses produce direct damage to the cell surface. They are mediated by IgM or

IgG

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)

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 client's blood pressure.

What causes the inflammation of nasal mucosa that is seen in allergic rhinitis?

Type I hypersensitivity reaction to Inhaled allergens

When describing the effects of second-generation antihistamines, which would the nurse address as being decreased?

sedation

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."

A nursing professor has just completed her lecture regarding hypersensitivity (allergic) responses, focused on Type I 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 immunoglobulin E (IgE)-induced response." "Anaphylaxis is a type I response." "It occurs within minutes of exposure to the antigen."

A 76-year-old client has been prescribed an oral antihistamine. What adverse effect presents a priority safety concern for older adult clients?

Drowsiness

Some antihistamines are used for more than one purpose. What antihistamine may also be effective as an antiemetic?

Hydroxyzine

A 74-year-old male client is diagnosed with hypertension, hyperlipidemia, angina, and gout. He presents to the health care provider's office with reports of seasonal allergies. His daughter has diphenhydramine at home, and he asks if it is safe for him to take it. The nurse is concerned because first-generation antihistamines may cause what adverse effects in older adults? (Select all that apply.)

Hypotension Syncope

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 med with apple juice

A client has an important presentation to make in 4 hours, and he needs relief from the congestion of seasonal rhinitis. The client calls the nurse, explains the situation, and tells the nurse that he cannot afford to be drowsy. What medication is most likely to meet this client's needs?

Loratadine

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

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?

N/V

The nurse is teaching a group of clients with allergic rhinitis about the use of their medications. What would be the most essential information to give these clients about preventing possible drug interactions?

Read drug labels before taking OTC medications.

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

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.

A client reports nasal congestion, sneezing, watery drainage from the nose, and itching of the throat, eyes, and ears. The nurse recognizes that these are consistent with what disorder?

allergic rhinitis

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 female client is prescribed a first-generation antihistamine for her allergies. The nurse would expect her to experience what adverse effect?

dry mouth

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 nurse regularly assesses clients for risk of anaphylactic reaction to prescribed medications. The nurse is aware that such reactions most commonly occur with what type of medication?

penicillins

Antihistamines are contraindicated or must be used with caution in various conditions. Which of the following are examples of these contraindications? Choose all that apply.

pregnant women narrow-angle glaucoma bladder neck obstruction