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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.
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The nurse would be especially alert for the development of which of the following when administering an antihistamine to an older adult? Select all that apply.
- A. Hypotension
- B. Hypertension
- C. Dry mouth
- D. Insomnia
- E. Sedation
Correct Answer: A,C,E
Rationale: Older adult clients are more likely to experience anticholinergic effects (dry mouth), dizziness, sedation, hypotension, and confusion while taking an antihistamine.
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.
A nurse is caring for a client with thick sputum who is having difficulty bringing up mucus. Which nursing diagnosis would the nurse most likely identify?
- A. Ineffective Airway Clearance
- B. Acute Pain
- C. Risk for Injury
- D. Impaired Oral Mucous Membranes
Correct Answer: A
Rationale: Thick sputum interferes with moving air effectively in and out of the respiratory tract. Therefore, the most likely nursing diagnosis would be Ineffective Airway Clearance. There is no evidence of pain. Risk for Injury would be appropriate if the client was experiencing sedation or drowsiness from the prescribed medication. Impaired Oral Mucous Membranes would be appropriate if the client was experiencing dry mouth from the medication.
A nurse is assigned to care for a client with a nonproductive cough. The client has been prescribed codeine sulfate. The nurse understands that this drug is contraindicated in which client?
- A. Client with head injury
- B. Client with COPD
- C. Premature infant
- D. Clients with asthma
Correct Answer: C
Rationale: Codeine sulfate is contraindicated in premature infants. Codeine sulfate should be used cautiously in clients with head injury, COPD, and asthma.
A nursing instructor is describing the advantages of using a second-generation antihistamine over a first-generation antihistamine. Which of the following would the instructor most likely include? Select all that apply.
- A. Less sedation
- B. Fewer anticholinergic effects
- C. Less nausea
- D. Can be used during pregnancy
- E. Can be used during lactation
Correct Answer: A,B
Rationale: Second-generation antihistamines cause less sedation and fewer anticholinergic effects because they selectively bind to peripheral rather than central H1 receptors. Some first-generation antihistamines can be used as antiemetics. Use of any antihistamine is contraindicated during pregnancy and lactation.