week 10 sherpath Flashcards
Match the drug class with its anticipated action.
Reduce viscosity of secretions to allow for ejection of mucus
Suppress harmful or nonproductive cough
Liquefies and loosens thick mucous secretions
Relieves nasal congestion
Answer choices
Decongestants
Antitussives
Mucolytics
Expectorants
Reduce viscosity of secretions to allow for ejection of mucus
Expectorants
Suppress harmful or nonproductive cough
Antitussives
Liquefies and loosens thick mucous secretions
Mucolytics
Relieves nasal congestion
Decongestants
By which mechanisms do expectorants loosen and thin respiratory secretions?
Select all that apply.
Direct activity with mucus to make it watery
Activation of sigma opioid receptors within the cough center
Direct stimulation of the secretory glands in the respiratory tract
Reflex stimulation in response to irritation of the gastrointestinal tract
Activation of alpha1-adrenergic receptors to constrict the -nasal blood vessels
Direct stimulation of the secretory glands in the respiratory tract
Reflex stimulation in response to irritation of the gastrointestinal tract
Which statements accurately describe the pharmacodynamics of dextromethorphan?
Select all that apply.
It can cause central nervous system (CNS) depression.
It possesses analgesic properties.
Its onset of action is 15 to 30 minutes.
Both its time to peak concentration and duration of action are 2.5 hours.
It suppresses the cough reflex by numbing the stretch receptor cells in the respiratory tract
Its onset of action is 15 to 30 minutes.
Both its time to peak concentration and duration of action are 2.5 hours.
Which drug undergoes metabolism to form cysteine, disulfides, and conjugates?
Acetylcysteine
Dextromethorphan
Guaifenesin
Pseudoephedrine
Acetylcysteine
How long can a patient expect the effects of extended-release pseudoephedrine to last?
15 to 30 minutes
30 to 120 minutes
3 to 4 hours
8 to 12 hours
8 to 12 hours
Which explanation describes why the nurse would call the health care provider because of a safety concern for Mr. Clark?
Dextromethorphan can significantly worsen his erectile dysfunction.
Dextromethorphan and pseudoephedrine can potentially worsen Mr. Clark’s glaucoma.
Pseudoephedrine can worsen gastrointestinal symptoms such as diarrhea, thereby exacerbating his irritable bowel syndrome.
The opioid antitussive represents a significant risk for abuse and addiction when given with pseudoephedrine and dextromethorphan, particularly in this patient.
Dextromethorphan and pseudoephedrine can potentially worsen Mr. Clark’s glaucoma.
Which instructions would a nurse include when teaching a patient about the administration of guaifenesin?
Select all that apply.
Avoid alcohol while receiving guaifenesin.
Limit use to 3 to 5 days to avoid rebound congestion.
Increase water intake up to 3 L per day unless contraindicated.
Contact a health care provider if the product needs to be used longer than 2 weeks.
Report a fever of 100.4°F (38°C) or higher or symptoms lasting longer than 3 to 4 days.
Avoid alcohol while receiving guaifenesin
Increase water intake up to 3 L per day unless contraindicated.
Report a fever of 100.4°F (38°C) or higher or symptoms lasting longer than 3 to 4 days.
Which conditions would alert a nurse to potentially unsafe treatment with pseudoephedrine?
Select all that apply.
Allergic rhinitis
Glaucoma
Hypertension
Hyperthyroidism
Osteoporosis
Glaucoma
Hypertension
Hyperthyroidism
Which nursing considerations about acetylcysteine are accurate?
Select all that apply.
Acetylcysteine can be safely mixed with other drugs for administration.
Patients with chronic obstructive pulmonary disease (COPD) should cautiously, if at all, use inhaled acetylcysteine.
If the patient is also prescribed a bronchodilator, acetylcysteine should be given 10 to 15 minutes before the bronchodilator.
Patients may develop runny nose, nausea, vomiting, drowsiness, headache, and dizziness while receiving acetylcysteine.
For the common cold and other respiratory conditions, the most common route of administration for acetylcysteine is inhalation through a nebulizer.
Patients with chronic obstructive pulmonary disease (COPD) should cautiously, if at all, use inhaled acetylcysteine.
Patients may develop runny nose, nausea, vomiting, drowsiness, headache, and dizziness while receiving acetylcysteine.
For the common cold and other respiratory conditions, the most common route of administration for acetylcysteine is inhalation through a nebulizer.
A patient asks a nurse when he or she should expect to start experiencing the effects of pseudoephedrine. Which time frame would the nurse share?
5 to 10 minutes
15 to 30 minutes
3 to 4 hours
5 to 6 hours
15 to 30 minutes
Which statements describe the pharmacokinetics of guaifenesin?
Select all that apply.
It is readily absorbed in the gastrointestinal tract.
It is largely protein bound.
The drug undergoes hydrolysis.
Its metabolism extensively involves the cytochrome P450 system.
Guaifenesin is excreted in urine.
It is readily absorbed in the gastrointestinal tract
The drug undergoes hydrolysis.
Guaifenesin is excreted in urine.
Which counseling point regarding the pharmacokinetics and pharmacodynamics of dextromethorphan would a nurse include in patient teaching?
Dextromethorphan’s effects last for about 12 hours.
Because it is an opioid drug, it may cause analgesia and excessive drowsiness.
The drug is an antitussive that works through suppressing the cough reflex within the cough center.
The drug is well absorbed in the lungs when inhaled deeply through a nebulizer.
The drug is an antitussive that works through suppressing the cough reflex within the cough center.
Which patients would a nurse determine can safely receive inhaled acetylcysteine?
Select all that apply.
A patient with diabetes
A patient with asthma
An older adult with a history of drug abuse
A patient with benign prostatic hyperplasia
An older adult with uncontrolled hypertension
A patient with diabetes
An older adult with a history of drug abuse
A patient with benign prostatic hyperplasia
An older adult with uncontrolled hypertension
Which clinical manifestation alerts a nurse to a possible drug-drug interaction in a patient with Parkinson disease who developed the common cold and is receiving selegiline and pseudoephedrine?
Hepatotoxicity
Hypertension
Muscle aches and cramps
Renal dysfunction
Hypertension
Which counseling points would a nurse provide a patient who has been prescribed an antitussive containing codeine?
Select all that apply.
Avoid alcohol while receiving the codeine-containing antitussive.
Potential side effects include sedation, dizziness, nausea, vomiting, and constipation.
Increase water intake to help loosen secretions for them to be coughed up.
Report any changes in sputum or mucus color, chest tightness, or difficulty breathing to a health care provider.
Avoid driving or other activities that require mental alertness in the event dizziness and sedation occur
Avoid alcohol while receiving the codeine-containing antitussive.
Potential side effects include sedation, dizziness, nausea, vomiting, and constipation.
Report any changes in sputum or mucus color, chest tightness, or difficulty breathing to a health care provider.
Avoid driving or other activities that require mental alertness in the event dizziness and sedation occur
Which drug causes a nurse to carefully consider the patient’s drug list for potential drug-drug interactions due to its metabolism through CYP450 2D6?
Acetylcysteine
Dextromethorphan
Guaifenesin
Pseudoephedrine
Dextromethorphan
Which class of drugs used in the management of pulmonary diseases decreases the production of and inhibits the release of leukotrienes, histamine, and prostaglandins; inhibits the activity of eosinophils and leukocytes; and decreases vascular permeability to decrease airway edema?
Anticholinergics
Beta2-adrenergic agonists
Glucocorticoids
Leukotriene modifiers
Glucocorticoids
Which range is the targeted therapeutic adult dosage range of theophylline?
1 to 5 mcg/mL
10 to 20 mcg/mL
30 to 40 mcg/mL
50 to 60 mcg/mL
10 to 20 mcg/mL
Which statement describes a pharmacodynamic difference between albuterol and salmeterol?
Albuterol is considered “long-acting” and salmeterol is considered “short-acting.”
Salmeterol’s effects last for 3 to 4 hours, and albuterol has an extended duration of action up to 12 hours.
Because of the onset of action, albuterol should not be used during an acute attack of asthma, but instead, salmeterol should be used.
Based on pharmacodynamics, albuterol is typically dosed as needed based on symptoms whereas salmeterol is dosed twice daily.
Based on pharmacodynamics, albuterol is typically dosed as needed based on symptoms whereas salmeterol is dosed twice daily.
Which statement is accurate regarding the pharmacokinetic profile of zafirlukast?
Food does not affect the absorption of zafirlukast.
Zafirlukast is minimally protein bound (<5%).
Zafirlukast undergoes hepatic metabolism.
Zafirlukast undergoes urinary excretion.
Zafirlukast undergoes hepatic metabolism.
When can a patient anticipate ipratropium’s onset of action?
2 to 3 minutes
5 to 15 minutes
20 to 30 minutes
45 to 60 minutes
5 to 15 min
Which teaching points would a nurse provide to Mr. Marx?
Select all that apply.
Encourage Mr. Marx to stop smoking.
Advise Mr. Marx to use the montelukast when he feels the onset of an asthma attack.
Emphasize the importance of taking his montelukast on a daily basis, even in the absence of symptoms.
Advise Mr. Marx to speak to his health care provider about making the albuterol -scheduled instead of as needed to gain better control of his asthma.
Educate Mr. Marx that montelukast may cause adrenal suppression and worsen his diabetes, and he should closely monitor his blood glucose levels.
Encourage Mr. Marx to stop smoking.
Emphasize the importance of taking his montelukast on a daily basis, even in the absence of symptoms.
Which patients will a nurse determine can safely receive treatment with a beta2-adrenergic agonist?
Select all that apply.
A patient with an active systemic fungal infection
A patient with benign prostatic hyperplasia
A patient with a cardiac dysrhythmia
A patient with hepatic encephalopathy
A patient with uncontrolled hypertension
A patient with an active systemic fungal infection
A patient with benign prostatic hyperplasia
A patient with hepatic encephalopathy
Which order of instructions would a nurse provide a patient using a metered-dose inhaler?
Breathe out through the mouth, and then take a slow deep breath through the mouth while pushing the top of the medication canister at the same time.
Wait for 2 minutes if a second dose is required.
Hold the mouthpiece 1 to 2 inches from the mouth, or place the inhaler mouthpiece between the teeth, sealing the lips around it.
Insert the medication canister into the plastic mouthpiece.
Shake the inhaler well and remove the cap from the mouthpiece.
Hold breath for a few seconds, exhaling slowly through pursed lips.
Insert the medication canister into the plastic mouthpiece.
Shake the inhaler well and remove the cap from the mouthpiece.
Hold the mouthpiece 1 to 2 inches from the mouth, or place the inhaler mouthpiece between the teeth, sealing the lips around it.
Breathe out through the mouth, and then take a slow deep breath through the mouth while pushing the top of the medication canister at the same time.
Hold breath for a few seconds, exhaling slowly through pursed lips.
Wait for 2 minutes if a second dose is required.