Antihistamines, Decongestans, Antitussives , and Expectorants Lilley: Pharmacology and the Nursing Process 8th edition

MULTIPLE CHOICE • When giving dextromethorphan, the nurse understands that this drug suppresses the cough reflex by which mechanism of action? • Causing depression of the central nervous system • Anesthetizing the stretch receptors • Having direct action on the cough center • Decreasing the viscosity of the bronchial secretions ANS: C Dextromethorphan suppresses the cough reflex through a direct action on the cough center. The other options are incorrect. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 572TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies • 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? • Constipation • Abdominal cramps • Drowsiness • Decreased libido ANS: C Drowsiness is usually the chief complaint of people who take antihistamines. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 567TOP: NURSING PROCESS: Assessment MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies • A gardener needs a decongestant because of seasonal allergy problems and asks the nurse whether he should take an oral form or a nasal spray. Which of these is a benefit of orally administered decongestants? • Immediate onset • A more potent effect • Lack of rebound congestion • Shorter duration ANS: C Drugs administered by the oral route produce prolonged decongestant effects, but the onset ofaction is more delayed and the effect less potent than those of decongestants applied topically.However, the clinical problem of rebound congestion associated with topically administered drugs is almost nonexistent with oral dosage forms. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 570TOP: NURSING PROCESS: Planning 2 MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies • A patient is taking guaifenesin (Humibid) as part of treatment for a sinus infection. Which instruction will the nurse include during patient teaching? • Force fluids to help loosen and liquefy secretions. • Report clear-colored sputum to the prescriber. • Avoid driving a car or operating heavy machinery because of the sedating effects. • Report symptoms that last longer than 2 days. ANS: A Forcing fluids 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. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 575TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort • 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? • Heartburn • Bradycardia • Drowsiness • Palpitations ANS: D