Nokea
Assessment of a client reveals that he is taking phenelzine (Nardil), a monoamine oxidase inhibitor, for depression. The client reports that he just started using dextromethorphan over the counter without consulting his primary health care provider. The nurse would be alert for which of the following? Select all that apply.
- A. Hypertension
- B. Fever
- C. Coma
- D. Constipation
- E. Shortness of breath
Correct Answer: B,C
Rationale: Coadministration of dextromethorphan and a monoamine oxidase inhibitor may result in hypotension, fever, nausea, leg jerking, and coma.
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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.
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 complains of increased sedation after the initiation of chlorpheniramine to treat her allergies. Which of the following would the nurse suggest to the client to treat her allergy symptoms that would result in less sedation? Select all that apply.
- A. Diphenhydramine (Benadryl)
- B. Clomastine (Tavist)
- C. Ioratadine (Claritin)
- D. Cetirizine (Zyrtec)
- E. Phenylephrine (Neo-Synephrine)
Correct Answer: C,D
Rationale: Loratadine and cetirizine are second-generation antihistamines, which can be less sedating than first-generation antihistamines, like chlorpheniramine, diphenhydramine, and clemastine. Phenylephrine is a decongestant used to treat nasal congestion.
Before administering an antitussive to a client, which of the following would the nurse assess? Select all that apply.
- A. Temperature
- B. Sputum presence
- C. Type of cough
- D. Bowel sounds
- E. Heart sounds
Correct Answer: A,B,C
Rationale: Vital signs, type of cough, presence of sputum, color and amount of sputum, home remedies used, and actions taken should be assessed prior to initiation of an antitussive. Bowel and heart sounds are not part of the preadministration assessment.
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.