Nokea
A client has been prescribed a nasal decongestant for nasal stuffiness due to a common cold. The client is also taking an antidepressant that is a monoamine oxidase inhibitor. The nurse would warn the client about which of the following.
- A. Hypotension
- B. Severe headache
- C. Sedation
- D. Bradycardia
Correct Answer: B
Rationale: The nurse should warn the client of the possibility of severe headache due to an interaction between the two drugs. Such an interaction may also result in hypertensive crisis instead of hypotension. Sedation and bradycardia do not occur when an MAOI and decongestant are used together.
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Based on the nurse's understanding of decongestants, the nurse would expect to administer this drug cautiously to a client with which of the following? Select all that apply.
- A. Diabetes
- B. Glaucoma
- C. Hypotension
- D. Hypothyroidism
- E. Arthritis
Correct Answer: A,B
Rationale: The nurse should administer decongestants cautiously to clients with diabetes, heart disease, hypertension, hyperthyroidism, benign prostatic hypertrophy, and glaucoma. These clients should contact their primary health care provider before taking over-the-counter decongestants.
The nurse understands that codeine-containing antitussives should be used cautiously in clients with which of the following conditions? Select all that apply.
- A. Pregnancy
- B. Convulsive disorders
- C. Prostatic hypertrophy
- D. Hyperlipidemia
- E. Type 2 diabetes
Correct Answer: A,B,C
Rationale: Codeine-containing antitussives should be used cautiously during pregnancy and labor and in clients with COPD, acute asthma attacks, pre-existing respiratory disorders, acute abdominal conditions, head injury, increased intracranial pressure, convulsive disorders, hepatic or renal impairment, and prostatic hypertrophy.
When teaching a client about using a decongestant in a nasal spray form, which instruction would the nurse include? Select all that apply.
- A. Recline on a bed and hang your head over the edge.
- B. Sniff hard for a few minutes after administration.
- C. Make sure the tip of the container is touching the nasal mucosa.
- D. Do not share the container with anyone except family members.
- E. Know that nasal burning or stinging may occur.
Correct Answer: B,E
Rationale: A client should be instructed to administer a nasal spray while sitting upright not allow the tip of the container to touch the nasal mucosa, and to sniff hard for a few minutes after administration. The client may experience some burning or stinging after the administration of the nasal spray. The container should not be shared with anyone.
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.
A client has been prescribed a decongestant drug for congestion associated with rhinitis. When teaching the client about this drug, which of the following would the nurse include as a possible adverse reaction?
- A. Decreased pulse rate
- B. Blurred vision
- C. Drowsiness
- D. Dryness of throat
Correct Answer: B
Rationale: The nurse should inform the client that blurred vision is a possible adverse reaction of decongestant drugs. Additionally, an increased and not decreased pulse rate may also be seen. Drowsiness is not seen with decongestant usage. Dryness of the nasal mucosa and not the throat may be seen with decongestant drugs, which are used mostly as topical sprays and drops.