Nokea
A client is suffering from rebound congestion. Which of the following would the nurse expect to do to help the client experience relief from rebound congestion? Select all that apply.
- A. Suggest the client switch from a topical decongestant to an oral product.
- B. Recommend the client switch from an oral decongestant to a topical product.
- C. Tell the client to abruptly discontinue the decongestant product.
- D. Advise the client to gradually discontinue the decongestant product.
- E. Suggest a saline irrigation of the nasal passages in place of the decongestant.
Correct Answer: A,D,E
Rationale: Rebound congestion can be treated by a switch from a topical to an oral decongestant, gradual discontinuation of the topical decongestant, or replacement of the topical decongestant with saline irrigation of the nasal passages.
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After administering a decongestant, which of the following would the nurse include in the ongoing assessment? Select all that apply.
- A. Heart sounds
- B. Blood pressure
- C. Level of congestion
- D. Therapeutic effect
- E. Pain assessment
Correct Answer: B,C,D
Rationale: The ongoing assessment for a client taking a decongestant should include assessment of blood pressure and pulse and asking about level of congestion, therapeutic effect, and adverse reactions.
A nurse is assigned to care for a client with bronchial irritation. The client is prescribed diphenhydramine. Before administering the drug, which of the following would the nurse do?
- A. Document color and amount of any sputum present.
- B. Record the previous prescriptions.
- C. Take vital signs every 4 hours.
- D. Assess the client's cardiovascular status.
Correct Answer: A
Rationale: Before drug administration, the nurse should document the color and amount of any sputum present. The nurse need not record the previous prescriptions; however, the nurse should determine if any drugs the client uses would potentially interact with diphenhydramine. The nurse needs to take the client's vital signs, but not every 4 hours. The nurse needs to assess the respiratory status of the client before administering mucolytics and expectorants, but not before administering diphenhydramine HCl. Assessing the client's cardiovascular status is not necessary.
The nurse understands that an expectorant is administered cautiously to a client with which condition?
- A. Renal impairment
- B. Persistent headache
- C. Persistent cough
- D. Seizure disorder
Correct Answer: C
Rationale: The nurse should use the expectorant drugs with caution in clients with persistent cough. The nurse should use antitussives with caution in clients with persistent headache. The nurse needs to use opioid antitussives cautiously in clients with renal impairment and seizure disorders.
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.
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.