Pharm Ch. 54 PrepU
Ms. James contacts her physician's office and asks if it is safe to use diphenhydramine while breast-feeding. The nurse's answer is based on the fact that diphenhydramine is a pregnancy category B drug and on which characteristic?
It may inhibit lactation.
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?"
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."
The nurse is providing education for a client who has been prescribed a second-generation antihistamine. Which client statement suggests a need for additional teaching?
"I'm really hoping that these pills will cure my allergies before summer starts."
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 has hypertension and wants to take a nasal decongestant for cold symptoms. Which statement by the nurse indicates the effect of hypertensive medications on hypertension?
"The administration of a nasal decongestant will increase blood pressure due to vasoconstriction of blood vessels."
The nurse is educating an adult client diagnosed with rhinosinusitis with viscous clear mucous about the prescribed guaifenesin 400 mg PO every 4 hours. Which statement made by the client establishes the need for further clarification?
"The drug will suppress my cough so I can sleep easier."
A male college student has presented to the campus medical clinic reporting cold symptoms that he has been experiencing for the past 2 weeks. He tells the nurse that he has been taking OTC decongestants twice daily since the onset of the cold. What teaching point should the nurse provide to this student?
"You might find yourself more congested than ever as your body compensates for your use of these drugs."
"I'm really hoping that these pills will cure my allergies before summer starts."
*"Are you experiencing any facial pain?" *"Are you feeling any sensation of pressure above your eyes?" *"Are you able to breathe through your nose?" *"Can you describe what your nasal drainage looks like?"
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
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
Which should be observed during ongoing assessment of a client taking a decongestant? (Select all that apply.)
*Blood pressure *Level of congestion *Therapeutic effect
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 patient receives dextromethorphan. The nurse would expect this drug to begin acting within which time frame?
25 to 30 minutes
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
Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug?
Antidote for acetaminophen poisoning
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 client is experiencing allergy symptoms after being exposed to environmental dust. This reaction involves the action of histamine, which is released by what cells?
Basophils
A nurse is caring for a patient who has been prescribed a nasal decongestant. Which of the following factors should the nurse assess before administering the drug?
Blood pressure
A patient has been prescribed a decongestant drug for congestion associated with rhinitis. Which possible side effect of the drug should the nurse caution the patient about?
Blurred vision
When instructing a client in how to use a topical nasal spray, what would the nurse emphasize to do first?
Clear the nasal passages.
A client having an allergic reaction to mold, describes chest tightness and difficulty breathing. Which process is occurring?
Contraction of smooth muscle in the bronchi
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
When describing the benefits of second-generation H1 receptor antagonists to those of first-generation H1 receptor antagonists, the nurse should cite what advantage?
Decreased sedation
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
A client calls the clinic and reports symptoms of a cold. The client is most concerned because the cold symptoms are preventing him from sleeping. The nurse would inform the client that what medication relieves cold symptoms and aids sleep?
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
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 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 nurse is assessing a client suspected of overdose with dextromethorphan. What assessment finding is suggestive of an overdose with the drug?
Hallucinations
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
What is the chemical mediator released in immune and inflammatory response to allergic reactions?
Histamine
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.
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
Which agent would a nurse expect the health care provider to prescribe for a client experiencing motion sickness?
Meclizine
Which would contraindicate the use of a topical nasal decongestant?
Nasal ulceration
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 is classified as a decongestant?
Oxymetazoline (Afrin)
An older adult client is administered dimenhydrinate. Which is the priority nursing intervention for this client?
Protect from injury.
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 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
A group of students demonstrate understanding of topical decongestants, identifying them as:
Sympathomimetics
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
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.
Expectorants elicit their effect by which mechanism?
Thinning respiratory secretions
A 21-year-old patient reports a mild stinging sensation on using a nasal spray containing a nasal decongestant. Which information should the nurse provide the patient?
This sensation usually disappears with continued use.
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 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
A client who is unsure whether symptoms are attributable to a cold or to allergies is taking pseudoephedrine as well as an antihistamine. This combination of drugs creates a risk for what adverse effect?
hypertension
Which condition would contraindicate the use of oxymetazoline?
hypertension
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
When the use of antihistamines result in dryness of the mouth, the nurse should recommend which to relieve the dryness? Select all that apply.
*Suck on sugarless hard candy. *Offer ice chips. *Take frequent sips of water.
Why are second-generation H1 receptor antagonists less likely to cause less central nervous system (CNS) depression? Select all that apply.
*They do not cross the blood-brain barrier. *They are selective for peripheral H1 receptors.
A client has been prescribed a first-generation antihistamine. What adverse effects should the nurse describe during client teaching? Select all that apply.
*urinary retention *blurred vision *dry mouth
An older adult client presents with sneezing, a nonproductive cough, and reports nasal congestion that began 5 days ago. What common, viral respiratory infection is the client likely experiencing?
common cold
