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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.
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A client is suffering from rebound congestion. Which of the following would the nurse expect to do to help the client experience relief from rebound congestion? Select all that apply.
- A. Suggest the client switch from a topical decongestant to an oral product.
- B. Recommend the client switch from an oral decongestant to a topical product.
- C. Tell the client to abruptly discontinue the decongestant product.
- D. Advise the client to gradually discontinue the decongestant product.
- E. Suggest a saline irrigation of the nasal passages in place of the decongestant.
Correct Answer: A,D,E
Rationale: Rebound congestion can be treated by a switch from a topical to an oral decongestant, gradual discontinuation of the topical decongestant, or replacement of the topical decongestant with saline irrigation of the nasal passages.
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 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.
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.
A nursing instructor is describing the advantages of using a second-generation antihistamine over a first-generation antihistamine. Which of the following would the instructor most likely include? Select all that apply.
- A. Less sedation
- B. Fewer anticholinergic effects
- C. Less nausea
- D. Can be used during pregnancy
- E. Can be used during lactation
Correct Answer: A,B
Rationale: Second-generation antihistamines cause less sedation and fewer anticholinergic effects because they selectively bind to peripheral rather than central H1 receptors. Some first-generation antihistamines can be used as antiemetics. Use of any antihistamine is contraindicated during pregnancy and lactation.