Pharm Ch. 31, 32, & 33- Respiratory

The nurse is providing education to a client regarding the use of an over-the-counter (OTC) antihistamine. Which client statement demonstrates a need for additional teaching?
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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 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."A female client is prescribed a first-generation antihistamine for her allergies. The nurse would expect her to experience what adverse effect?Dry mouthWhat causes the inflammation of nasal mucosa that is seen in allergic rhinitis?Type I hypersensitivity reaction to Inhaled allergensThe 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 vomitingWhat type of antihistamine is typically preferred for older adults?Second-generationA 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."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?DiphenhydramineA 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?LoratadineA nursing professor has just finished a lecture regarding histamines. Which of the following statements made by students would indicate that the teaching was effective? Select all that apply."Histamines are synthesized and stored in most body tissues." "Histamines are located mainly in secretory granules of mast cells and basophils." "Histamines diffuse rapidly into other tissues once released."What is one of the benefits related to second generation antihistamine administration in older adults?They do not impair thinking.The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects?Excessive salivationThe 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.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 rhinitisA 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?LoratadineWhen describing the effects of second-generation antihistamines, which would the nurse address as being decreased?SedationWhen considering possible side effects, which client should be considered for a prescription of cetirizine rather than diphenhydramine?Any adult older than 56-years-of age.Allergic drug reactions should be considered when new signs and symptoms develop or when they differ from the usual manifestations of the illness being treated. Which of the following are reactions needing special attention? Select all that apply.Follows ingestion of a drug, especially one known to produce allergic reactions Is unpredictable and occurs in only a few patients when many patients receive the suspected drug Occurs minutes or hours after a second or subsequent exposure Increases eosinophils in blood or tissueA 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.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 allergensA 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 urticariaWhat medication should be prescribed to minimize the risk associated with a blood transfusion for a client with a history of a previous transfusion reaction?diphenhydramineWhich statement accurately describes an aspect of serum sickness?Is a delayed hypersensitivity reaction.A client diagnosed with allergic rhinitis has expressed a lack of interest in treating the disorder. When providing client teaching, what should the nurse identify as potential effects of avoiding treatment? Select all that apply.chronic fatigue insomnia sinusitis asthmaA 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?DiphenhydraminePseudoephedrine (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.A male client presents to the emergency department with his 4-year-old child. The child self-administered diphenhydramine of an unknown quantity. In overdosage of diphenhydramine, the nurse is aware that the child may experience what problems? (Select all that apply.)Hallucinations ConvulsionsWhat hospital procedure has the greatest potential to cause an anaphylactoid reaction?administration of contrast media for diagnostic testsAn older adult client is administered dimenhydrinate. Which is the priority nursing intervention for this client?Protect from injury.The nursing instructor is describing the four types of hypersensitivity reactions. What alternate name might the instructor use to identify type IV hypersensitivity?Delayed hypersensitivityWhat would be the nurse's best response if a client calls the clinic and reports that he has had a persistent cough for 2 weeks and asks the nurse for a recommendation for a cough medicine?"You should come to the clinic to be evaluated. A cough that lasts that long might indicate a medical problem."A 25-year-old female client presents at the clinic with bronchitis. The health care provider orders guaifenesin. Which instruction should the clinic nurse offer when teaching the client about the medication?"Drink at least two liters of fluids each day."A client is encouraged to take guaifenesin to loosen the secretions due to a viral respiratory infection. What should the nurse suggest to the client to make the medication work more effectively?Increase fluid intakeA 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 congestionThe instructor is teaching about the use of mucolytics. The nursing student demonstrates an understanding of the action of the mucolytic drugs when stating which?They are used to break down the thickness of secretions.A client visits the clinic and is diagnosed with acute sinusitis. To promote sinus drainage, what medication might be ordered?Topical decongestantsA 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?DecongestantsAn 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 coldA 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.Decongestants should be used cautiously in clients with which medical conditions? Select all that apply.Diabetes Thyroid disease Glaucoma HypertensionA 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?PseudoephedrineAcetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug?Antidote for acetaminophen poisoningWhat is an adverse reaction commonly experienced by people taking nasal decongestants?Rebound congestionThe nurse is providing education to a client who has been diagnosed with a sinus infection. What would the nurse identify as a major cause of this disorder?inflammatory processesAfter 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 group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example?GuaifenesinA client reports having difficulty finding the over-the-counter (OTC) decongestant that the client used in the past. What assessment question should the nurse ask to help address the client's concern?"Did the medication contain pseudoephedrine?"A 43-year-old man is taking pseudoephedrine (Sudafed) for sinusitis. He calls the clinic to report that it feels like his heart is racing and that he can "feel his heart beating fast." The nurse will instruct him to:stop taking the medication and come to the clinic as ordered by the health care provider.A male client presents to the health care provider's office with reports of inability to breathe freely. When the nurse reviews his use of over-the-counter medications, it is discovered that the client routinely uses nasal spray three times a day for 1 year. The nurse knows that what may be causing this client's continuous nasal congestion?Rebound nasal swellingWhat statement best describes how the common cold is effected by and managed using medication therapy?The tendencies to overmedicate and use antibiotics inappropriately with the common cold are widespread and pose significant risk for complications and drug resistance.The nurse is educating a client with a cough about the use of taking dextromethorphan for relief. What statement made by the client indicates teaching has been effective?"I will take my medication and not eat or drink for 30 minutes."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 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 drugA 76-year-old man has a history of heart disease, and has been prescribed an oral decongestant. The nurse is concerned with this prescription because of the risk for which?serious cardiovascular effects.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 membranesThe nursing instructor is discussing the use of nasal decongestants and shares what reason for their effectiveness?They come into direct contact with nasal mucosa.A client has been using guaifenesin for a cough that accompanied a common cold. The client calls the nurse help line and states that he thinks he is having an adverse reaction to the medication. Which symptoms are adverse effects of this medication? Select all that apply.Nausea Rash HeadacheA client presents at the clinic with a dry nonproductive cough. The client is diagnosed with bronchitis, and it has been determined that assistance is needed in thinning the sputum so the cough can become productive. What does the nurse expect the provider will prescribe?GuaifenesinA nurse is assigned to care for a client who is prescribed dextromethorphan. The client's history reveals that the client is also taking a monoamine oxidase inhibitor for depression. The nurse would assess the client for which effect?Jerking leg motionsThe nursing instructor is teaching students about the administration of nasal sprays. According to the instructor, the correct patient position for administering the sprays is closest tohigh Fowler's position.A client has just been admitted for an overdose of pseudoephedrine. The nurse's assessment of the client should prioritize what system?cardiovascularA male client is diagnosed with chronic bronchitis. What would the nurse expect to be one of his physical reports?Retention of secretionsWhich statement by the client would alert the nurse that more education is needed regarding a client receiving an antitussive?"I should keep the room warm."A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions?MucolyticA 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?decongestantWhat 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 lozengesThe nursing instructor is discussing over-the-counter cold remedies. According to the instructor, these products typically combinea decongestant, an analgesic, and an antihistamine.Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine?ineffective airway clearanceA client diagnosed with the common cold asks the nurse about taking an over-the-counter (OTC) cold medications. What statement should the nurse include in client teaching?"Follow the instructions on the label so that you don't end up making the congestion worse."A 29-year-old client has sinusitis and has been prescribed a topical nasal decongestant. What instructions should the nurse provide?increase fluids to 2 L/d.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 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?"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 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.Which is classified as a decongestant?Oxymetazoline (Afrin)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."Which agent acts directly on the medullary cough center?CodeineThe nurse is providing education to a client who has been prescribed theophylline. The nurse interprets what client statement as a sign of successful teaching?"I should avoid beverages that contain caffeine."The nurse is caring for a 38-year-old client who is beginning treatment with albuterol. Which should the nurse identify as a potential adverse effect of the drug?TachycardiaThe client has been diagnosed with asthma and is being treated with two inhalers, albuterol and flunisolide. The nurse teaches the client that the two medications should be administered in what order?Albuterol first, wait five minutes and then follow with flunisolideA client who has been admitted to the healthcare center has been diagnosed with emphysema. The arterial blood gas results reveal respiratory acidosis. Based on this information, what should the nurse explain to the client that is the cause of the respiratory acidosis?Excess carbon dioxide in the bloodThe pulmonologist sees many patients daily who suffer from a variety of respiratory disorders. What are some of the common signs and symptoms many of these patients present? (Select all that apply.)Cough Increased secretions Mucosal congestionThe nurse is reviewing a client's morning blood work and notes a theophylline level of 22.2 mcg/mL (123.21 µmol/L). What action should the nurse take?Inform the health care provider that the client has toxic theophylline levels.A client arrives in the emergency room with an attack of acute bronchiectasis. What is the principal pathologic finding in the diagnosis of bronchiectasis?Chronic, irreversible dilation of the bronchi and bronchiolesWhat action by the client would indicate that the client understands how to use an inhaler?The client holds his or her breath for several seconds after compressing the canister.A client is prescribed salmeterol. The nurse would expect this drug to be administered by which route?InhalationWhy are inhaled steroids used to treat asthma and COPD?They act locally to decrease release of inflammatory mediatorsA nurse is teaching a newly diagnosed client with asthma how to manage the disease. What should the nurse encourage this client to do?stop smoking cigarettesThe nurse is caring for a client with chronic obstructive pulmonary disease. The plan of care will focus on what client problem?Lack of patent airwayThe nurse is caring for a 38-year-old client with asthma who has been started on albuterol. What assessment finding should the nurse most likely attribute to adverse medication effects?The client's heart rate is 99 beats/min.The nurse is monitoring a premature infant diagnosed with respiratory distress syndrome (RDS). Which assessment finding will serve to demonstrate that the instillation of surfactant as a treatment has been effective?Clear breath soundsA patient tells you that her friend has recommended using caffeine to treat her asthma. How would you appropriately respond to this patient?"Prescription drugs have been proven effective in treating asthma, and caffeine hasn't been. Since uncontrolled asthma can be deadly, I wouldn't recommend that you switch from your medications to caffeine."Adrenergics are a category of bronchodilators used in the treatment of asthma and COPD. A specific adverse effect contraindicates these medications for clients with cardiac tachyarrhythmias. In what conditions is cautious use recommended? (Select all that apply.)Hypertension Seizure disorders Diabetes mellitusMr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?Albuterol causes relaxation of the bronchial smooth muscles.A client diagnosed with asthma has been prescribed tiotropium. What should the nurse teach the client about this drug? Select all that apply."It is an anticholinergic." "You only need to take it once a day." "It has a rapid onset of action and a long duration."A 42-year-old male client has a history of smoking for 20 years. The client states he is feeling fine and asks why stopping smoking is necessary. What information might the nurse share with the client about smoking?Smoking decreases the size of the tubes leading to the lungsAfter reviewing information about drugs used to treat lower respiratory system conditions, a group of nursing students demonstrate understanding of the information when they identify which as an example of a short-acting beta-2 agonist (SABA)?AlbuterolA client, experiencing respiratory distress related bronchi constriction, will benefit from what therapeutic action provided by anticholinergic medication therapy?Relaxation of smooth muscleA 70-year-old client is being treated for chronic obstructive pulmonary disease (COPD) with theophylline. What will be a priority assessment by the nurse?Use of nicotineThe parents of a 7-year-old client who has been diagnosed with allergic asthma are being taught about their son's medication regimen. The nurse is teaching about the appropriate use of a "rescue drug" for acute exacerbations. What drug should the nurse suggests the parents to use in these situations?AlbuterolThe nurse provides care for a client who comes to the outpatient clinic once per week to receive a dose of Zemaira. When planning the client's assessments, what guideline should the nurse follow?The client has a high risk of emphysema.A client with asthma has been prescribed an anti-inflammatory medication. How does an anti-inflammatory drug reduce this client's bronchoconstriction?Decreasing airway hypereactivity to stimuliDuring the summer, a female client experiences increased periods of acute symptoms of her asthma. The health care provider increases the dose frequency of which of her medications?AlbuterolWhat is the most effective method used to monitor clients with asthma that they can use at home?Peak-flow monitorA client is experiencing an acute asthmatic attack. Which agent would be most effective?Beta-2 selective adrenergic agonistA nurse is providing health teaching to a newly diagnosed asthmatic client. The client has been prescribed theophylline. The nurse should encourage this client to stop:smoking cigarettes.A client is prescribed a leukotriene receptor antagonist. The nurse should evaluate the effectiveness of the medication therapy based on the long term management of symptoms associated with which respiratory condition?AsthmaA client has been diagnosed with chronic obstructive pulmonary disease. The client has been prescribed bronchodilators by nebulizer for home use. The nurse should teach the client to:sit in a fully upright position when administering the medication.A nurse would expect to increase the dosage of theophylline if the client has a current history of which of the following?Cigarette smokingRespiratory symptoms are treated with many types of drugs, includinganti-inflammatory agents.The nurse is evaluating the education of a client that uses albuterol for an acute asthma attack. The nurse knows that the lesson has been effective when the client states that albuterol is which of the following types of medication?SABAA female client presents to the emergency department with acutely deteriorating asthma. Her husband tells the nurse that his wife takes salmeterol. He then tells the nurse that he gave her three extra puffs when she became ill. What statement is correct in this situation?Salmeterol is contraindicated based on his wife's condition.A client, experiencing respiratory distress related bronchi constriction, will benefit from what therapeutic action provided by anticholinergic medication therapy?Relaxation of smooth muscleA male client is concerned because ever since he began his antiasthma medication, his GERD symptoms are worse. The nurse explains that his symptoms are worse because his asthma medications have what effect?They relax the gastresophageal sphincter.A group of students are reviewing the various drugs that affect inflammation. The students demonstrate understanding when they identify which agent as a mast cell stabilizer?CromolynA client with chronic bronchial asthma is prescribed montelukast. What will the nurse instruct the client to avoid taking?AspirinA client has been prescribed medication therapy for the treatment of newly diagnosed asthma. During teaching, the nurse should alert the client to potential exacerbation of what concurrent medical condition?gastroesophageal reflux diseaseAn adult client with newly diagnosed asthma presents for client education regarding situations that could precipitate an asthma attack. In this teaching, which precipitants would the nurse state may trigger an attack? Select all that apply.Exercise Allergens Mold Cigarette smokeWhich would the nurse identify as being involved with asthma?Hyperactive airwaysA nurse is providing education to a 56-year-old man who is admitted to the emergency department with an acute asthma attack. The nurse's initial assessment reveals that the patient has a history of pneumonia, drinks large quantities of coffee, and eats a high-calorie diet. Albuterol is prescribed for him. The important consideration when the nurse is preparing a teaching plan will be that the patienthas a high coffee intake.After teaching a group of students about leukotriene receptor antagonists, the instructor determines a need for additional teaching when the students identify which agent as an example?FluticasoneShane, a 25-year-old man, is diagnosed with asthma. He began an albuterol MDI 2 weeks ago. He reports that his symptoms persist in spite of using albuterol MDI as prescribed. What advice should the nurse give the client?Contact the health care provider to obtain adjunctive medications.Why are inhaled steroids used to treat asthma and COPD?The FDA has ordered a black box warning for the drug omalizumab. The nurse knows that what are the risks associated with this medication?AnaphylaxisA nurse is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The nurse will question the patient about her intake of which of the following?CoffeeA 75-year-old client is diagnosed with COPD. The health care provider orders an adrenergic bronchodilator via inhaler and a spacer. What are the main risks associated with the drug for this client? (Select all that apply.)Excessive cardiac stimulation CNS stimulationA nurse is caring for a client with chronic bronchiectasis. The nurse should assess the patient for which clinical manifestation?Purulent coughA nurse is administering levalbuterol to a client. The nurse would administer this drug by which route?InhalationA client is experiencing an episode of status asthmaticus. What is the primary challenge facing the staff as they attempt to manage the client's respiratory crisis?The bronchospasm does not respond to usual treatment measuresA client who has chronic bronchial asthma has had a mast cell stabilizer prescribed. What drug would the provider prescribe?Cromolyn