Nokea
A patient is taking guaifenesin as part of treatment for a sinus infection. Which instruction will the nurse include during patient teaching?
- A. Increase fluid intake to help loosen and liquefy secretions.
- B. Report clear-colored sputum to the prescriber.
- C. Avoid driving a car or operating heavy machinery because of the sedating effects.
- D. Report symptoms that last longer than 2 days.
Correct Answer: A
Rationale: Increasing fluid intake helps to loosen and liquefy secretions. The patient must be fully aware that any fever, chest tightness, change in sputum from clear to colored, difficult or noisy breathing, activity intolerance, or weakness needs to be reported. The patient must also report to the prescriber a fever of higher than 100.4?°F (38?°C) or symptoms that last longer than 3 to 4 days. Decongestants do not cause sedation, and therefore the patient does not need to avoid driving a car or operating heavy machinery.
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A patient with a tracheostomy has difficulty removing excessive, thick mucus from the respiratory tract. The nurse expects that which drug will be ordered to aid in the removal of mucus?
- A. Guaifenesin
- B. Benzonatate
- C. Diphenhydramine
- D. Dextromethorphan
Correct Answer: A
Rationale: Expectorants such as guaifenesin work to loosen and thin sputum and the bronchial secretions, thereby indirectly diminishing the tendency to cough. The other drugs listed do not have this effect.
During a routine checkup, a patient states that she is unable to take the prescribed antihistamine because of one of its most common adverse effects. The nurse suspects that which adverse effect has been bothering this patient?
- A. Constipation
- B. Abdominal cramps
- C. Drowsiness
- D. Decreased libido
Correct Answer: C
Rationale: Drowsiness is usually the main side effect that bothers people who take antihistamines.
When teaching a patient who will be receiving antihistamines, the nurse will include which instructions?
- A. Antihistamines are generally safe to take with over-the-counter medications.
- B. Take the medication on an empty stomach to maximize absorption of the drug.
- C. Take the medication with food to minimize gastrointestinal distress.
- D. Drink extra fluids if possible.
- E. Antihistamines may cause restlessness and disturbed sleep.
- F. Avoid activities that require alertness until you know how adverse effects are tolerated.
Correct Answer: C,D,F
Rationale: Antihistamines should be taken with food, even though this slightly reduces the absorption of the drug, so as to minimize the gastrointestinal upset that can occur. Over-the-counter medications must not be taken with an antihistamine unless approved by the physician because of the serious drug interactions that may occur. Drinking extra fluids will help to ease the removal of secretions, and activities that require alertness, such as driving, must not be engaged in until the patient knows how he or she responds to the sedating effects of antihistamines.
A patient asks the nurse about the uses of the herbal product echinacea. Which use will the nurse include in the response?
- A. Memory enhancement
- B. Boosting the immune system
- C. Improving mood
- D. Promoting relaxation
Correct Answer: B
Rationale: Common uses of echinacea include stimulation of the immune system, antisepsis, treatment of viral infections and influenza-like respiratory tract infections, and promotion of the healing of wounds and chronic ulcerations. The other options are incorrect.
A patient has been advised to add an adrenergic decongestant nasal spray to treat a cold. The nurse will include which instruction?
- A. You won't see effects for at least 1 week.
- B. Limit use of this spray to 3 to 5 days.
- C. Continue the spray until nasal stuffiness has resolved.
- D. Avoid use of this spray if a fever develops.
Correct Answer: B
Rationale: Frequent, long-term, or excessive use of adrenergic nasal decongestants may lead to rebound congestion if used beyond the recommended time. The other instructions are incorrect.