Module 6: Respiratory Agents
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."
What statement made by a client suggests a need for further teaching on the risk factors associated with drug allergies?
"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, 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 occurs within minutes of exposure to the antigen." "It is an immunoglobulin E (IgE)-induced response." "Anaphylaxis is a type I response."
A professor of pharmacology has just completed her lecture regarding hypersensitivity (allergic) responses. Her lecture focused on Type IV reactions. Which of the following statements made by her students will show that the students understood the material?
"The test for TB is this type of reaction." "It is also called delayed hypersensitivity." "It is is a cell-mediated response in which sensitized T lymphocytes react with an antigen to cause inflammation."
A nursing professor has just completed her lecture regarding hypersensitivity (allergic) responses. Her lecture focused on Type II reactions. Which of the following statements made by her students will show that the students understood the material
"Type II responses are mediated by IgG or IgM, generating direct damage to the cell surface." "This kind of reaction can occur during a blood transfusion." "It can be an adverse effect of a drug.
A female client is diagnosed with severe kidney failure. The nurse would expect the health care provider to order diphenhydramine with what dosing interval?
12 to 18 hours
A client receives diphenhydramine orally. The nurse would expect this drug to begin acting within which time frame?
15-30 minutes
You are caring for a client who takes a monoamine oxidase inhibitor (MAOI) for treatment of depression. The client occasionally self-administers an over-the-counter antihistamine to control allergy symptoms. What effect could this client experience as a result of combining these two medications?
Adverse effects of the antihistamine will be more severe.
A client's report of nasal congestion, itching, sneezing, and watery drainage, including itching of the throat, eyes, and ears are consistent with what situation?
Allergic rhinitis
A 75-year-old client comes to the office reporting increased tiredness and confusion. The nurse obtains a full medication history. The client's current medications include lisinopril 20mg QD, alrazolam 0.25mg PRN, glyburide 5mg BID, acetaminophen 500 mg Q6 hours, and diphenhydramine 25 mg QD. Which medications could be causing the client's increased tiredness and confusion? Select all that apply:
Alprazolam Diphenhydramine
A client reports a hacking cough. The client asks if taking an antihistamine would be helpful. The nurse's best response is:
Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough.
A client has been prescribed an antihistamine for the treatment of seasonal allergies. What dietary guidelines should the nurse provide to the client?
Avoid drinking alcohol while taking antihistamines
Your client has a history of post-transfusion reactions. Her medical provider has ordered medication to prevent this. Which of the following medications would you anticipate being ordered for this client?
Benadryl
A male client presents to the emergency department with symptoms of a gastrointestinal bleed. The health care provider orders a blood transfusion. The client has a history of anaphylaxis. The provider orders the administration of what drug before the blood transfusion?
Diphenhydramine
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 nonselectively binding to central and peripheral H1 receptors?
Diphenhydramine
A 76-year-old client has been prescribed an oral antihistamine. What adverse effect presents a priority safety concern for older adult clients?
Drowsiness
The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects?
Excessive salivation
Promethazine (phenergan) is the only antihistamine formulated as a nasal spray for topical use. True or false.
False
True or false: Second generation antihistamines are associated with a higher risk of sedation than first generation antihistamines
False
Second-generation antihistamines were developed to remove the sedation of first generation drugs. Which of the following antihistamines is a second-generation drug?
Fexofenadine
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
The term antihistamine generally indicates classic or traditional drugs. These drugs prevent or reduce most of the physiologic effects that histamine normally induces at H1 receptor sites. Which of the following are direct results of H1 antagonists?
Inhibit smooth muscle constriction in blood vessels and the respiratory and GI tracts Decrease capillary permeability Decrease salivation and tear formation
Which statement accurately describes an aspect of serum sickness?
Is a delayed hypersensitivity reaction
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
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
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
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
All of the following are drugs less commonly associated with anaphylactic reactions EXCEPT:
Penicillin
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
Combining first-generation antihistamines with sedating agents can can result in what adverse effect?
Respiratory depression
What type of antihistamine is typically preferred for older adults?
Second generation
When describing the effects of second-generation antihistamines, which would the nurse address as being decreased?
Sedation
An 82-year-old client is prescribed an antihistamine for the relief of allergic rhinitis. Which findings would the nurse most likely assess in this client? Select all that apply.
Sedation Dry throat Confusion
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 tablet with food
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
Allergic rhinitis is inflammation of the nasal mucosa caused by a type I hypersensitivity reaction to inhaled allergens. True or false?
True
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
What causes the inflammation of nasal mucosa that is seen in allergic rhinitis?
Type I hypersensitivity reaction to Inhaled allergens
The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which are some effects?
Urinary retention or frequency, sedation, dry mouth, blurred vision, and gastrointestinal distress
When developing the teaching plan for a client receiving an antihistamine, which would the nurse include?
Using sugarless candies or lozenges to combat dry mouth Advising the client to avoid alcohol consumption
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.
First-generation antihistamines frequently cause what adverse effect?
urinary retention blurred vision dry mouth
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 teaching junior-level students conducts a lecture regarding allergic rhinitis. Which of the following statements made by the students verifies the lecture was effective
"It is inflammation of nasal mucosa caused by a type I hypersensitivity reaction to inhaled allergens." "It is characterized by nasal congestion, itching, sneezing, and watery drainage." "People with a personal history of other allergic disorders are likely to have allergic rhinitis."
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?
"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 female client is prescribed a first-generation antihistamine for her allergies. The nurse would expect her to experience what adverse effect?
Dry mouth
