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A client with vasomotor rhinitis has been prescribed an antihistamine. The client is eager to know whether the prescribed antihistamine may cause excessive sedation. Which antihistamine would the nurse identify as having very little sedative effect?
- A. Brompheniramine
- B. Clemastine
- C. Chlorpheniramine
- D. Azelastine
Correct Answer: D
Rationale: The nurse should assure the client that azelastine has very little sedative effect; it is a second-generation antihistamine with little effect on central nervous system (CNS) depression. Brompheniramine, clemastine, and chlorpheniramine are first-generation antihistamines. Sedation is seen more often with first-generation antihistamines.
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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.
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.
When describing the actions of upper respiratory system drugs, a nursing instructor explains that which of the following exerts its effect by increasing the production of secretions, thereby decreasing the viscosity? Select all that apply.
- A. Benzonatate
- B. Guaifenesin
- C. Codeine
- D. Potassium iodide
- E. Dextromethorphan
Correct Answer: A,D
Rationale: Benzonatate and potassium iodide are expectorants, which increase the production of secretions, thus making the secretions less viscous. Guaifenesin, codeine, and dextromethorphan are antitussives, which suppress cough.
A client taking metoprolol (Lopressor) 50 mg one tablet twice daily begins taking over-the-counter pseudoephedrine. The nurse would assess for which of the following? Select all that apply.
- A. Hyperglycemic episode
- B. Hypertensive episode
- C. Rebound congestion
- D. Hypoglycemic episode
- E. Bradycardic episode
Correct Answer: B,E
Rationale: A client taking a beta-adrenergic blocker, such as metoprolol, and a decongestant, such as pseudoephedrine, may develop an initial hypertensive episode followed by a bradycardic episode.
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.