Pharm Exam 1: Ch. 54 Upper Respiratory Drugs
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 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
The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects?
Excessive salivation
T/F: Dextromethorphan is helpful in patients with cystic fibrosis to decrease the spasmodic coughing because it moistens the mucous membranes and decreases the viscosity of respiratory secretions.
False
The nurse is providing education to a client with asthma on the therapeutic action of inhaled corticosteroid agents. How will the nurse describe the action?
Inhaled corticosteroid agents reduce airway inflammation.
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
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
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
Why should a nurse instruct a client to avoid taking guaifenesin with combination OTC cold products?
OTC cold products can also contain guaifenesin
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 is an adverse reaction commonly experienced by people taking nasal decongestants?
Rebound congestion
A client is prescribed oxymetazoline. Which assessment data would indicate that the drug is effective?
Breathing pattern is regular and without difficulty.
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 nurse should recognize that using pseudoephedrine to treat allergic rhinitis requires cautious use with clients who have what condition?
Coronary artery disease -causes vasoconstriction
A client asks the nurse how long to use oxymetazoline (Afrin) nasal spray for nasal congestion. What is the nurse's best response?
"Consult with your primary care provider."
A client is currently taking pseudoephedrine to help manage the nasal congestion resulting from seasonal allergies. When the client reports being extremely restless and having difficulty getting to sleep at night, what assessment question will the nurse ask to best provide interventions to minimize those effects?
"How much coffee, tea, and soda do you drink daily?"
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."
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 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."
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.)
-Importance of reading the label for ingredients and dosage -need to follow the directions for how often to give the drug -avoidance of use in children under age 2
What home remedies are effective for mouth dryness and cough? (Select all that apply.)
-humidification of the environment -adequate fluid intake -sucking on hard candy or throat lozenges
What elicits their pharmacological effect by reducing swelling in the nasal passages by vasoconstriction? (Select all that apply.)
-phenylephrine -oxymetazoline
Codeine containing antitussives should be used cautiously in clients with which conditions?
-pregnancy -convulsive disorders -prostatic hypertrophy -COPD -acute asthma -head injury acute abdominal conditions -hepatic or renal impairment
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 candy -offer ice chips -take frequent sips of water
A patient receives dextromethorphan. The nurse would expect this drug to begin acting within which time frame?
25-30 min
A patient receives guaifenesin. The nurse would expect the drug to begin acting within which time frame?
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
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.
An adult client has asked the nurse to recommend an OTC cold remedy. Before making a recommendation, the nurse should implement which intervention?
Assess the client for health problems that may contraindicate the use of a particular remedy.
A client informs the nurse about taking pseudoephedrine for the relief of nasal congestion due to the common cold. In which situation should the nurse suggest that the client not use this medication since it is a contraindication for this health care concern?
The client is being treated for severe hypertension
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.
A nurse is caring for a client who is having difficulty mobilizing respiratory secretions. Which of the following drugs should the nurse expect to administer to the client?
acetylcysteine -mucolytic that loosens thick respiratory secretions
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
Which of the following would a nurse identify as a surfactant?
beractant
The nurse is assessing a client who is taking diphenhydramine for relief of seasonal allergies. Which finding should prompt the nurse to suspect that the resident is experiencing an anticholinergic effect of the medication?
blurry vision
A client has just been admitted for an overdose of pseudoephedrine. The nurse's assessment of the client should prioritize what system?
cardiovascular
The nurse is planning care for a client who is experiencing excessive respiratory tract secretions. What intervention should the nurse include?
deep breathing and coughing exercises
a nursing student is researching which antihistamine drug that elicits its antihistamine effects by selectively binding to peripheral
desloratadine
A nurse is preparing to administer phenylephrine to a client. The nurse should identify which manifestation is an adverse effect?
headache
Which condition would contraindicate the use of oxymetazoline?
hypertension
Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine?
ineffective airway clearance
expectorants
medications like guaifensein (Mucinex) that liquify lower respiratory tract secretions and make them easier to cough up
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
Benzonatate (Tessalon) should not be used by:
pregnant women bc of potential adverse effects on the fetus
A nurse is teaching a client about the use of an expectorant to treat a cough. The nurse should include that an expectorant has which of the following therapeutic effects?
reduces surface tension
A nurse is caring for a client who is taking codeine. What is the priority asssessment?
respirations -greatest risk to clients who are taking codeine, an opioid agonist, is severe respiratory depression
When describing the effects of second-generation antihistamines, which would the nurse address as being decreased?
sedation
A nurse is teaching a client about the use of a mucolytic to treat a cough. Thenurse should include that a mucolytic has which of the following therapeutic effects?
thins and loosens secretions by decreasing mucous viscosity
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."
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.
Oral decongestants may be helpful in patients with:
otitis media by opening the nasal passage and improving drainage of the eustachian tube
Which would the nurse expect to administer as a nasal spray?
oxymetazoline
Patients who need decongestants but cannot tolerate an oral systemic medication may be prescribed a(n) _______ decongestant.
topical nasal
The health care provider suggests that a client use guaifenesin to help his cough. The nurse instructs the client to call the health care provider if he continues to have a productive cough after which amount of time?
1 week -Guaifenesin should not be used for more than 1 week; if cough persists, encourage the client to seek health care
Which would contraindicate the use of a topical nasal decongestant?
Nasal ulceration
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?"
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 nurse is teaching an adult client about diphenhydramine. The nurse should inform the client to expect which of the following adverse effects while taking this drug?
drowsiness
A nurse should identify the dextromethorphan can have what effects when combined with morphine?
potentiation of depression of CNS actions -combining dextromethorphan with an opioid increases risk for decreased respirations and other depressed CNS responses
A nurse is teaching a client about the use of antihistamine to treat allergic rhinitis. The nurse should explain that these drugs are effective because they perform which of the following actions?
prevent histamine from binding to receptors -treat allergic rhinitis and reduce swelling by blocking histamine from binding to the receptor sites
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."
After teaching a group of parents about the use of over-the-counter cough and cold products with their children, which statement indicates the need for additional teaching?
"We can use the adult brand, but we just have to decrease the amount."
A male client presents to the health care provider's office with allergy-related symptoms that interfere with his job as a car salesman. What nasal spray does the nurse expect to be ordered?
Azelastine (Astelin)
Which client, acknowledging the regular use of pseudoephedrine, should be assessed further for the possible risk of contraindications to the use of this medication?
a client currently being treated for depression
Legal restrictions apply to the purchase of pseudoephedrine because of what risk?
drug abuse -can alter pseudoephedrine and epinephrine into methamphetamine
The nurse taking a medical history determines that the client takes a decongestant regularly for a variety of seasonal allergies. What other medication identified in the client's current medication history would constitute an immediate risk to the client's health?
monoamine oxidase inhibitor (MAOI)
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?
Dihenhydramine
Mucolytics are often used for
patients with cystic fibrosis, COPD, or tuberculosis.
