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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.
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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 child will be receiving diphenhydramine (Benadryl), 5 mg/kg/day, in divided doses, every 6 hours. The child weighs 80 pounds. Identify how many milligrams of medication will the child receive with each dose.
Correct Answer: 45.5 mg
Rationale: 80 pounds ?· 2.2 = 36.36 kg, which rounds to 36.4 kg; 5 mg/kg/day ?? 36.4 kg = 182 mg/day. With doses given every 6 hours, there will be 4 total doses in a 24-hour period (24 ?· 6 = 4). To calculate milligrams per dose: 182 mg/day ?· 4 doses/day = 45.5 mg/dose.
The nurse will instruct patients about a possible systemic effect that may occur if excessive amounts of topically applied adrenergic nasal decongestants are used. Which systemic effect may occur?
- A. Heartburn
- B. Bradycardia
- C. Drowsiness
- D. Palpitations
Correct Answer: D
Rationale: Although a topically applied adrenergic nasal decongestant can be absorbed into the bloodstream, the amount absorbed is usually too small to cause systemic effects at normal dosages. Excessive dosages of these medications, however, are more likely to cause systemic effects elsewhere in the body. These may include cardiovascular effects, such as hypertension and palpitations, and central nervous system effects, such as headache, nervousness, and dizziness. 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.
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.