Drugs for Upper Respiratory Disorders Unit 8.1
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Questions and Answers

A client is receiving dextromethorphan (Benylin). The nurse knows the drug is exerting its therapeutic effect when the client experiences:

  • decreased coughing. (correct)
  • thinning of secretions.
  • bronchodilation.
  • relief of nasal congestion.

The nurse is teaching an older adult client about guaifenesin (Robitussin). Which information is appropriate to include in this teaching? (Select all that apply.)

  • Read labels on over-the-counter drugs and check with health care provider before taking cold remedies. (correct)
  • Advise client to contact health care provider if cough persists more than 2 days. (correct)
  • Take the drug with a glass of water. (correct)
  • Take the drug at bedtime.

A client has been diagnosed with the common cold. The nurse should question if which drug is ordered to treat this client?

  • Antihistamines
  • Expectorants
  • Antibiotics (correct)
  • Antitussives

Which medication is a first-generation antihistamine?

<p>Diphenhydramine (Benadryl) (B)</p> Signup and view all the answers

When teaching a client about use of nasal decongestant sprays, the nurse informs the client that they are most effective when administered for how many days?

<p>3 days (B)</p> Signup and view all the answers

Before administering diphenhydramine (Benadryl) to a client, it is most important for the nurse to assess the client for a history of:

<p>narrow-angle glaucoma. (B)</p> Signup and view all the answers

Which statement about dextromethorphan does the nurse identify as being true?

<p>It suppresses the cough center of the medulla. (B)</p> Signup and view all the answers

What is the etiology of the common cold?

<p>Rhinovirus (D)</p> Signup and view all the answers

Which part of the respiratory tract does the common cold affect?

<p>Nasopharyngeal tract (B)</p> Signup and view all the answers

What is the primary symptom of acute rhinitis?

<p>Inflammation of the nasal mucous membranes (D)</p> Signup and view all the answers

What causes allergic rhinitis?

<p>Pollen or foreign substances (C)</p> Signup and view all the answers

What is the primary action of antihistamines?

<p>They block histamine</p> Signup and view all the answers

What are some of the uses of antihistamines?

<p>All of the above (D)</p> Signup and view all the answers

Which of the following is a first-generation antihistamine?

<p>Diphenhydramine (C)</p> Signup and view all the answers

Why are second-generation antihistamines preferred over first-generation antihistamines?

<p>They have fewer side effects (D)</p> Signup and view all the answers

Which of the following is a common side effect of diphenhydramine?

<p>Drowsiness (A)</p> Signup and view all the answers

What is one of the advantages of loratadine over diphenhydramine?

<p>It causes less drowsiness (D)</p> Signup and view all the answers

What should be assessed in a client's medical history before administering antihistamines?

<p>All of the above (D)</p> Signup and view all the answers

What is one nursing intervention when administering diphenhydramine?

<p>Dilute the medication with water (C)</p> Signup and view all the answers

Operating motor vehicles is generally recommended after taking diphenhydramine due to its drowsiness effect.

<p>False (B)</p> Signup and view all the answers

What should be avoided alongside antihistamines?

<p>Alcohol (B)</p> Signup and view all the answers

What is a recommended remedy for temporary relief of dry mouth caused by antihistamines?

<p>All of the above (D)</p> Signup and view all the answers

What is a caution for using antihistamines in children?

<p>Antihistamines can cause excitability in children (B)</p> Signup and view all the answers

Older adults are typically less sensitive to the effects of antihistamines compared to younger adults.

<p>False (B)</p> Signup and view all the answers

What is the primary action of nasal decongestants?

<p>They constrict blood vessels in the nasal passages (C)</p> Signup and view all the answers

What is a potential side effect of long-term use of nasal decongestants?

<p>Rebound congestion (C)</p> Signup and view all the answers

What is the primary use of intranasal glucocorticoids?

<p>Treat allergic rhinitis (D)</p> Signup and view all the answers

Why are intranasal glucocorticoids often preferred for long-term treatment of allergic rhinitis?

<p>They do not cause rebound congestion (B)</p> Signup and view all the answers

What is a common side effect of oxymetazoline?

<p>Nervousness (C)</p> Signup and view all the answers

Oxymetazoline should only be used for a maximum of 3 days.

<p>True (A)</p> Signup and view all the answers

Who should avoid using oxymetazoline?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary action of antitussives?

<p>They suppress the cough reflex (C)</p> Signup and view all the answers

Which type of antitussive is dextromethorphan?

<p>Nonnarcotic (B)</p> Signup and view all the answers

What is the primary use of dextromethorphan?

<p>Treat dry cough (B)</p> Signup and view all the answers

Who should avoid using dextromethorphan?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary action of guaifenesin?

<p>It helps to thin mucus (A)</p> Signup and view all the answers

What are some common uses for guaifenesin?

<p>All of the above (D)</p> Signup and view all the answers

What is a common side effect of guaifenesin?

<p>Nausea and vomiting (C)</p> Signup and view all the answers

What is an important nursing assessment before administering any cold medication?

<p>All of the above (D)</p> Signup and view all the answers

When administering diphenhydramine IV push, what is an important consideration for the nurse?

<p>Administer the medication slowly to avoid burning (A)</p> Signup and view all the answers

Why is it important to avoid driving after taking diphenhydramine?

<p>All of the above (D)</p> Signup and view all the answers

It is recommended to use sugarless candy or gum for temporary relief of dry mouth caused by antihistamines.

<p>True (A)</p> Signup and view all the answers

Older adults are generally more sensitive to the effects of antihistamines compared to younger adults.

<p>True (A)</p> Signup and view all the answers

What should a nurse teach a client about the use of nasal decongestant sprays?

<p>Use them for no longer than 3 days to avoid rebound congestion (C)</p> Signup and view all the answers

What is the primary reason intranasal glucocorticoids are preferred for long-term management of allergic rhinitis?

<p>They do not cause rebound congestion (D)</p> Signup and view all the answers

Oxymetazoline can potentially cause side effects like nervousness and jittery behavior.

<p>True (A)</p> Signup and view all the answers

Oxymetazoline should ideally be limited to a maximum of 3 days of use.

<p>True (A)</p> Signup and view all the answers

What is the primary use of guaifenesin?

<p>To thin mucus (D)</p> Signup and view all the answers

When administering medication to a patient, it is important to assess for allergies, respiratory status, and cardiac status.

<p>True (A)</p> Signup and view all the answers

What is an important consideration for nurses when administering diphenhydramine IV push?

<p>All of the above (D)</p> Signup and view all the answers

Diphenhydramine can cause side effects that impair driving, including drowsiness, dizziness, blurry vision, and a slowed reaction time.

<p>True (A)</p> Signup and view all the answers

Sugarless candy or gum can help with dry mouth, a common side effect of some antihistamines.

<p>True (A)</p> Signup and view all the answers

What important teaching should a nurse provide regarding the use of nasal decongestant sprays?

<p>Use them for no longer than 3 days to avoid rebound congestion (D)</p> Signup and view all the answers

Why are intranasal glucocorticoids generally preferred for long-term management of allergic rhinitis?

<p>They do not cause rebound congestion (D)</p> Signup and view all the answers

Oxymetazoline can cause side effects such as nervousness and jittery behavior.

<p>True (A)</p> Signup and view all the answers

The recommended maximum duration for using oxymetazoline is 3 days.

<p>True (A)</p> Signup and view all the answers

Flashcards

Common Cold Etiology

Caused by rhinovirus, affecting the nasopharyngeal tract.

Acute Rhinitis

Inflammation of nasal mucous membranes, often part of the common cold.

Allergic Rhinitis

Hay fever caused by allergens like pollen, causing nasal inflammation.

First-Generation Antihistamines

Antihistamines like diphenhydramine that block histamine to reduce allergic reactions, but can cause drowsiness.

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Diphenhydramine Action

Blocks histamine, reducing allergic response; common for itching, sleep, and cough relief.

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Diphenhydramine Uses

Treats allergic rhinitis, itching, prevents motion sickness, and used as a sleep aid or antitussive.

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Second-Generation Antihistamines

Non-sedating antihistamines like loratadine, offering similar benefits without drowsiness.

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Loratadine Action

Works like first-generation but reduces drowsiness and anticholinergic side effects.

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Loratadine Uses

Treats allergic rhinitis and itching; longer-lasting.

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Antihistamine Side Effects

Drowsiness, dry mouth, decreased secretions, dizziness, blurred vision, urinary retention, and constipation.

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Nasal Congestion Cause

Dilation of nasal blood vessels due to infection, inflammation, or allergies.

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Nasal Decongestants

Systemic or nasal drugs that stimulate alpha-adrenergic receptors to constrict nasal blood vessels.

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Fluticasone Action

Reduces inflammation, a steroid-based nasal spray.

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Fluticasone Uses

Treats allergic rhinitis, inflammation, short-term use, no rebound congestion.

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Frequent Decongestant Use

Can lead to tolerance and rebound congestion; should not use more than 3 days.

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Antitussives

Drugs that suppress the cough reflex.

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Dextromethorphan Use

Suppresses nonproductive coughs temporarily and thins secretions.

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Antitussives Contraindications

Avoid use in cases of COPD, chronic productive cough, or children under 2.

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Expectorants

Loosen bronchial secretions for easier coughing.

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Guaifenesin Action

Loosens bronchial secretions, allowing easier removal, useful during colds and flus.

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Cold Medication Care Plan

Detailed guidelines for managing cold symptoms through medications and overall care.

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Dextromethorphan Therapeutic Effect

Reduces coughing by acting on the cough center, measured by the client's decreased cough frequency.

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Guaifenesin Teaching Points

Taking with water to aid in mucus thinning, checking labels, and alerting the physician about any persisting symptoms.

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Common Cold Treatment

Antibiotics are not effective against viral infections like the common cold; use antihistamines, decongestants, antitussives, or expectorants.

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First Generation Antihistamine Example

Diphenhydramine (Benadryl).

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Max Nasal Decongestant Use

Limit to 3 days to avoid rebound congestion.

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Diphenhydramine Contraindication

Avoid in clients with narrow-angle glaucoma due to its anticholinergic effects.

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What causes the common cold?

The rhinovirus causes the common cold, which affects the nasopharyngeal tract.

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What is acute rhinitis?

Acute rhinitis is inflammation of the nasal mucous membranes, often a symptom of the common cold.

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What is allergic rhinitis?

Allergic rhinitis, or hay fever, is caused by allergens like pollen and results in inflammation of the nasal membranes.

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How do first-generation antihistamines work?

First-generation antihistamines like diphenhydramine (Benadryl) block histamine, reducing allergic reactions, but often cause drowsiness.

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What are some uses of first-generation antihistamines?

First-generation antihistamines are used for allergies, itching from allergic reactions, motion sickness prevention, sleep aid, and cough relief.

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How do second-generation antihistamines differ?

Second-generation antihistamines like loratadine (Claritin) work like first-generation but have fewer side effects, specifically drowsiness.

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What are common side effects of antihistamines?

Antihistamines can cause drowsiness, dry mouth, decreased secretions, dizziness, blurred vision, urinary retention, and constipation.

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What is nasal congestion?

Nasal congestion occurs when nasal blood vessels dilate, caused by infection, inflammation, or allergies.

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What are nasal decongestants?

Nasal decongestants are medications, both systemic and nasal, that stimulate alpha-adrenergic receptors, constricting blood vessels in the nose.

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How do intranasal glucocorticoids like fluticasone work?

Intranasal glucocorticoids like fluticasone reduce inflammation in the nose through their steroid action.

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When are intranasal glucocorticoids used?

Intranasal glucocorticoids are used for allergic rhinitis and other nasal inflammation, especially during allergy seasons.

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What are the potential side effects of nasal decongestants?

Nasal decongestants can cause nervousness, jitteriness, restlessness, hypertension, hyperglycemia, and tachycardia.

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Why should nasal decongestants be used cautiously?

Long-term use of nasal decongestants can cause tolerance and rebound congestion, requiring careful monitoring.

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What are antitussives?

Antitussives are medications designed to suppress the cough reflex, helping to reduce coughing.

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How does dextromethorphan work?

Dextromethorphan is a non-narcotic antitussive that works on the cough control center in the medulla to reduce coughing.

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What are some uses for dextromethorphan?

Dextromethorphan helps provide temporary suppression of nonproductive cough and can thin tenacious secretions.

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When is dextromethorphan contraindicated?

Dextromethorphan is contraindicated in patients with COPD, chronic productive coughs, and children under 2 years old.

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What are expectorants?

Expectorants are medications that loosen bronchial secretions, making them easier to cough up.

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How does guaifenesin work?

Guaifenesin is an expectorant that loosens bronchial secretions, helpful for colds, flu, and respiratory illnesses.

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What are some side effects of guaifenesin?

Guaifenesin can cause nausea, vomiting, drowsiness, and headaches.

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When are antibiotics NOT used for a cold?

Antibiotics are ineffective against viral infections like the common cold, so they are not used.

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What are some important aspects of a cold medication care plan?

A cold medication care plan includes monitoring vital signs, secretions, cough suppression, proper nasal spray use, increasing fluids, avoiding driving if drowsy, reading drug labels, and seeking medical attention if symptoms persist.

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Which of these is a first-generation antihistamine?

Diphenhydramine (Benadryl) is a first-generation antihistamine.

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How long should nasal decongestants be used at most?

Nasal decongestant sprays should be used for a maximum of 3 days to prevent rebound congestion.

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What should be assessed before administering diphenhydramine?

Before administering diphenhydramine, it's important to assess for narrow-angle glaucoma as it can worsen.

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Which statement about dextromethorphan is true?

Dextromethorphan suppresses the cough center in the medulla, a non-narcotic antitussive.

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What is the primary action of dextromethorphan?

Dextromethorphan suppresses the cough reflex by targeting the cough center in the medulla.

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Study Notes

Drugs for Upper Respiratory Disorders

  • Upper Respiratory Disorders
    • Common cold: Etiology - Rhinovirus, affects the nasopharyngeal tract
    • Acute rhinitis: Inflammation of nasal mucous membranes
    • Allergic rhinitis: Hay fever, due to pollen or foreign substances

Antihistamines

  • First-generation antihistamines
    • Diphenhydramine: Blocks histamine, decreasing allergic response. Used for allergic rhinitis, itching, motion sickness, sleep aid, and antitussive.
  • Side effects: Anticholinergic - drowsiness, dry mouth, decreased secretions, dizziness, blurred vision, urinary retention, constipation, photosensitivity, excitability in children
  • Second-generation antihistamines
    • Loratadine: Works similarly to first generation but without drowsiness or anticholinergic side effects. Used for allergic rhinitis and itching. Long-acting, longer half-life.

Nursing Process: Antihistamines

  • Assessment: Baseline vital signs, medical/medication history, signs/symptoms of urinary dysfunction, cardiac and respiratory status, environmental exposures for allergies
  • Nursing interventions/teaching: Administer in large muscle IM, dilute diphenhydramine for IV over time to avoid burning, avoid operating vehicles or machinery if drowsy, avoid alcohol/other CNS depressants, follow the prescription orders exactly, sugarless candy can relieve mouth dryness temporary, caution when giving to children (excitability possible)
  • Older adults can be more sensitive and experience confusion

Nasal Decongestants

  • Nasal congestion: Dilation of nasal blood vessels due to infection, inflammation, allergies causes fluid buildup in tissues, leading to nasal swelling.
  • Nasal decongestants: Systemic and Nasal decongestants
    • Stimulate alpha-adrenergic receptors
    • Produce nasal vascular vasoconstriction
    • Shrink nasal mucous membranes
    • Reduces nasal secretions
    • Rebound congestion can occur with overuse
    • Use for nasal congestion
  • Side effects/Adverse reactions: Nervousness, jittery, restless, hypertension, hyperglycemia, tachycardia
  • Frequent use: May lead to tolerance, rebound nasal congestion, avoid using more than 3 days

Intranasal Glucocorticoids

  • Fluticasone: Steroidal action decreasing inflammation, used for allergic rhinitis, short term use during allergy season only, no rebound congestion

Antitussives - Dextromethorphan Hydrobromide

  • Action: Acts on cough control center; suppresses cough reflex
    • Suppresses non-productive coughs, to reduce viscosity of tenacious secretions
  • Contraindications: COPD, chronic productive coughing, children under 2
  • Interactions: Other CNS depressants, grapefruit juice

Expectorants

  • Guaifenesin: Action: Loosens bronchial secretions, enabling easier coughing. Use for common cold, flu, respiratory illnesses
  • Side Effects: Nausea/vomiting, drowsiness, headache

Cold Medication Care Plan

  • Assessment: Vital signs (check for tachycardia, hypertension), medical/medication history, cardiac/respiratory status, allergies

  • Interventions/teaching: Monitor vital signs, monitor respiratory status and secretions, educate on nasal spray use, increase fluids especially with expectorant, do not drive until effects known, decongestants can lead to insomnia, take early decongestants during day, decongestants can cause rebound congestion with overuse, read labels for all multiple symptom control medications, contact health care provider if cough lasts more than a week

Practice Questions and Answers (Selected)

  • Practice Question #1: Which effect does dextromethorphan produce?

    • Correct answer (and rationale): Decreased coughing (acts on cough center)

  • Practice Question #2: Appropriate client teaching with Guaifenesin?

    • Correct answers and rationale: Taking with glass of water to loosen secretions and checking OTC medication list with health care professional

  • Practice Question #3: Which drug would you question a doctor about for a common cold?

    • Correct answer (and rationale): antibiotics (viruses, not bacteria, cause common cold)

  • Practice Question #4: Which is a first-generation antihistamine?

    • Correct answer (and rationale): Diphenhydramine

  • Practice Question #5: How long should nasal decongestants be used?

    • Correct answer (and rationale): 3 days (prevents rebound congestion)

  • Practice Question #6: Before administering diphenhydramine, what should be checked?

    • Correct answer (and rationale): History of narrow-angle glaucoma (due to anticholinergic effects)

  • Practice Question #7: What is true of dextromethorphan?

    • Correct answer and rationale: It suppresses the cough center in the medulla.

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Upper Respiratory Drugs PDF

Description

This quiz covers various drugs used to treat upper respiratory disorders, focusing on common conditions like the common cold and rhinitis. It also examines the two generations of antihistamines, their uses, and side effects. Test your knowledge on the nursing process related to these medications.

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