The nurse would be especially alert for the development of w...

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.

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A 21-year-old client complains of a mild stinging sensation on using a nasal spray decongestant. Which response by the nurse would be most appropriate?

A. You need to stop the medication immediately.
B. The dose is probably too strong and needs to be reduced.
C. This sensation is common and usually disappears with continued use.
D. We better contact your primary health care provider right away.

Correct Answer: C

Rationale: The nurse needs to assure the client that the mild stinging sensation usually disappears with continued use. The drug needs to be stopped only if the stinging sensation is severe. The dose of the medication does not need to be altered. The primary health care provider does not need to be consulted immediately in the presence of a mild stinging sensation.

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.

When teaching a client about using a decongestant in a nasal spray form, which instruction would the nurse include? Select all that apply.

A. Recline on a bed and hang your head over the edge.
B. Sniff hard for a few minutes after administration.
C. Make sure the tip of the container is touching the nasal mucosa.
D. Do not share the container with anyone except family members.
E. Know that nasal burning or stinging may occur.

Correct Answer: B,E

Rationale: A client should be instructed to administer a nasal spray while sitting upright not allow the tip of the container to touch the nasal mucosa, and to sniff hard for a few minutes after administration. The client may experience some burning or stinging after the administration of the nasal spray. The container should not be shared with anyone.

After teaching a group of nursing students about antihistamines, the instructor determines that the teaching was successful when the students identify which of the following as less sedating? Select all that apply.

A. Loratadine (Claritin)
B. Fexofenadine (Allegra)
C. Cetirizine (Zyrtec)
D. Brompheniramine (Lodrane)
E. Clemastine (Tavist)

Correct Answer: A,B,C

Rationale: Loratadine, fexofenadine, and cetirizine are considered second-generation antihistamines that are less sedating than first-generation antihistamines (brompheniramine and clemastine).

When assessing an older client who is receiving an antihistamine, the nurse integrates knowledge of which of the following as contributing to the client's higher risk of injury? Select all that apply.

A. Hearing loss
B. Steady gait
C. Visual impairment
D. Hypertension
E. Diabetes

Correct Answer: A,C

Rationale: Older adult clients are more likely to experience injury from dizziness because with age comes an increased risk for falls due to sensorimotor deficits (hearing loss, visual impairment) or unsteady gait.