NUR 2092 Ch 54 Drugs acting on the upper respiratory system
A client has expressed frustration stating, "I've been taking an over-the-counter (OTC) decongestant for several days and it still hasn't really cured my cold." What teaching point should the nurse convey to the client?
"Drugs like this can often relieve some of the symptoms of a cold, but they won't cure it."
After teaching a client who is receiving an antitussive about the drug, which statement indicates the need for additional teaching?
"I'll keep the room warm and toasty."
The nurse is caring for a client with cystic fibrosis who is receiving dornase alfa by nebulizer to help thin secretions. What statement by the client indicates a need for further instruction?
"I'm glad that this medication will address all of my symptoms."
A patient receives guaifenesin. The nurse would expect the drug to begin acting within which time frame?
30 minutes
A client is admitted after overdose with acetaminophen. What medication would the nurse expect to be administered?
Acetylcysteine
What drug enhances the output of respiratory tract fluid by reducing the adhesiveness and surface tension of the fluid, which facilitates the removal of viscous mucus?
Acetylcysteine
What home remedies are effective for mouth dryness and cough?
Adequate fluid intake Humidification of the environment Sucking on hard candy or throat lozenges
Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug? Treatment of bronchospasm
Antidote for acetaminophen poisoning
A client, scheduled to receive one unit of packed red blood cells, has a history of an allergic reaction to a transfusion in the past. What class of medication will assist in preventing a reaction to the packed red blood cell transfusion?
Antihistamines
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.
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
A client prescribed codeine for a persistent, debilitating cough tells the nurse, "I was sure that codeine was a narcotic that people take for pain." The nurse should cite what mechanism of action when describing this use of codeine?
Depression of the cough center in the medulla oblongata
The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects?
Excessive salivation
A group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example?
Guaifenesin
Increasing fluid intake
Increasing fluid intake
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 client is prescribed oxymetazoline, a decongestant, for the treatment of hay fever. What should the nurse evaluate to assess the efficacy of therapy?
Maintenance of effective airway clearance
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
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
Which would the nurse expect to administer as a nasal spray?
Oxymetazoline
A client reports anxiety, restlessness, nausea, and vomiting after using a nasal decongestant. Which drug should the nurse consider as the cause for these side effects?
Pseudoephedrine
Which agent would the nurse instruct a client to use orally?
Pseudoephedrine
What is an adverse reaction commonly experienced by people taking nasal decongestants?
Rebound congestion
A male client is diagnosed with chronic bronchitis. What would the nurse expect to be one of his physical reports?
Retention of secretions
Which of the following is an adverse reaction to topical nasal steroids?
Suppression of healing
An instructor is describing topical decongestants as belonging to which class?
Sympathomimetics
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.
After teaching a group of students about topical nasal steroid decongestants, the instructor determines the need for additional teaching when the students identify which as an example?
Tetrahydrozoline
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
Antitussive agents should be used with caution in patients who have a history of addiction.
True
While reviewing the medication histories, the nurse notices that several clients regularly take over-the-counter dextromethorphan. Which client does the nurse recognize as having an increased risk for developing an adverse reaction to dextromethorphan based on his or her medical diagnosis and medication therapy?
an adult diagnosed with chronic depression being treated with a selegiline
The nursing instructor is teaching about antitussives and their side effects. What ingredient found in some antitussives does the instructor tell students can cause drowsiness?
antihistamine
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
rebound congestion
rebound congestion
The nurse is educating an older adult client diagnosed with rhinosinusitis in an outpatient clinic about the prescribed topical oxymetazoline. The client has a history of hypertension and coronary artery disease. Which statement made by the client establishes the need for further clarification?
"I can take over-the-counter pseudoephedrine, too."
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 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 caring for a client in the hospital is being discharged today with a prescription for benzonatate (Tessalon Perles) 200 mg one capsule 3 times daily. What would the nurse tell the client about this prescription during discharge counseling? (Select all that apply.)
Benzonatate can cause GI upset and sedation. The client should drink plenty fluids.
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 has self-medicated with an over-the-counter (OTC) decongestant nasal spray for several weeks in order to help prevent "getting the common cold." The nurse should educate the client concerning the risk for which result of long-term use of OTC cold remedies? Select all that apply.
Chronic nasal congestion Damage to the nasal mucosa
What should be observed during ongoing assessment of a client taking an antitussive? (Select all that apply.)
Lung sounds Frequency of cough Therapeutic effect Pain assessment
When the use of antihistamines result in dryness of the mouth, the nurse should recommend which to relieve the dryness? Select all that apply.
Offer ice chips. Suck on sugarless hard candy. Take frequent sips of water.
A gerontological nurse has encouraged a group of caregivers who work with older adults to avoid administering first-generation H1 receptor antagonists to their clients. The nurse's cautionary message is an acknowledgment of what possible nursing diagnosis?
Risk for falls related to sedation
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
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 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?
Pseudoephedrine
