Nokea
A client complains of increased sedation after the initiation of chlorpheniramine to treat her allergies. Which of the following would the nurse suggest to the client to treat her allergy symptoms that would result in less sedation? Select all that apply.
- A. Diphenhydramine (Benadryl)
- B. Clomastine (Tavist)
- C. Ioratadine (Claritin)
- D. Cetirizine (Zyrtec)
- E. Phenylephrine (Neo-Synephrine)
Correct Answer: C,D
Rationale: Loratadine and cetirizine are second-generation antihistamines, which can be less sedating than first-generation antihistamines, like chlorpheniramine, diphenhydramine, and clemastine. Phenylephrine is a decongestant used to treat nasal congestion.
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Eucalyptus is an herbal product that can be used as a decongestant and expectorant. In which of the following client populations would the nurse identify a contraindication for its use? Select all that apply.
- A. Pregnant females
- B. Children younger than 2 years of age
- C. Lactating females
- D. Postmenopausal females
- E. Men
Correct Answer: A,B,C
Rationale: The use of eucalyptus is contraindicated during pregnancy and lactation, as well as in people who are hypersensitive to eucalyptus and in children younger than 2 years of age.
After teaching a client about his upper respiratory drug therapy, the nurse determines that additional teaching is needed when the client identifies which of the following as a reason to notify his primary health care provider?
- A. Cough changes from nonproductive to productive.
- B. Sputum appears clear.
- C. Sputum increases.
- D. Shortness of breath occurs.
Correct Answer: B
Rationale: The client should notify his primary health care provider if the type of cough changes, sputum changes color or increases, and shortness of breath occurs. Clear sputum is normal.
The nurse is preparing to administer a drug that acts by reducing the swelling in the nasal passages by vasoconstriction. Which of the following might the nurse be administering? Select all that apply.
- A. Loratadine
- B. Guaifenesin
- C. Dextromethorphan
- D. Phenylephrine
- E. Oxymetazoline
Correct Answer: D,E
Rationale: Phenylephrine and oxymetazoline are decongestants that reduce swelling in the nasal passages by vasoconstriction. Loratadine is an antihistamine, guaifenesin is an expectorant, and dextromethorphan is a centrally acting antitussive.
A client with a nonproductive cough has been prescribed dextromethorphan HBr LiquiCaps. What instructions should the nurse provide the client to promote an optimal response to therapy?
- A. Take the drug with a glass of milk.
- B. Swallow the whole tablet and do not chew it.
- C. Dissolve the tablet in water and take the drug.
- D. Take the drug on an empty stomach.
Correct Answer: B
Rationale: The nurse should instruct the client to swallow the whole tablet and not to chew it to ensure that the drug is absorbed properly. The nurse need not instruct the client to take the drug with a glass of milk, dissolve the tablet in water and take the drug, or take the drug on an empty stomach.
Assessment of a client reveals that he is taking phenelzine (Nardil), a monoamine oxidase inhibitor, for depression. The client reports that he just started using dextromethorphan over the counter without consulting his primary health care provider. The nurse would be alert for which of the following? Select all that apply.
- A. Hypertension
- B. Fever
- C. Coma
- D. Constipation
- E. Shortness of breath
Correct Answer: B,C
Rationale: Coadministration of dextromethorphan and a monoamine oxidase inhibitor may result in hypotension, fever, nausea, leg jerking, and coma.