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Roach 32,33
Question | Answer |
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Most antitussives depress the cough center located in the | medulla and are called centrally-acting drugs. |
Codeine and dextromethorphan are examples of | centrally-acting antitussives. |
One antitussive acts peripherally by anesthetizingstretch receptors in the respiratory passages, thereby | decreasing coughing. |
Benzonatate (Tessalon) is the | peripherally-acting antitussive. |
acetylcysteine | Stomatitis, nausea, vom-iting, fever, drowsiness,bronchospasm, irritationof the trachea andbronchi |
Antitussives are contraindicated in patients with | knownhypersensitivity to the drugs. |
The opioid antitussives(those with codeine) are contraindicated in | prematureinfants or during labor when delivery of a premature infant isanticipated. |
During the preadministrationassessment, the nurse documents the type | of cough (pro-ductive, nonproductive) and describes the color and amount of any sputum present. |
The patient is asked todescribe actions taken or home remedies used to treat thecough independently. The nurse takes | The nurse takes and records vitalsigns because some patients with a productive coughmay have an infection. |
During the ongoing assessment, the nurse observes for atherapeutic effect (e.g., coughing decreases). The nurse | auscultates lung sounds and takes vital signs periodi-cally. |
When a patient has a cough, the nurse describesand records in the chart the | ype of cough (productive ornonproductive of sputum) and the frequency of cough-ing. |
The nurse also notes and records whether the coughinterrupts | sleep and whether it causes pain in the chestor other parts of the body. |
PATIENT RECEIVING A MUCOLYTIC OR AN EXPECTORANT After administering the drug, the nurse notes any increase in | sputum or change in consistency |
The nursedocuments, on the patient’s chart, a description of | the sputum raised. |
Patients with thick, tenacious mucus may have | difficulty breathing. |
t is important to notify theprimary health care provider if the patient has difficultybreathing because of an | Inability to raise sputum andclear the respiratory passages. |
Immediately before and after treatment with themucolytic acetylcysteine, the nurse | auscultates the lungsand records the findings of both assessments on thepatient’s chart. Between treatments, the nurse evaluatesthe patient’s respiratory status and records these findingson the patient’s chart. |
hese evaluations aid the primaryhealth care provider in determining | the effectiveness of therapy. |
For the patient with thicksputum, the nurse encourages a fluid intake of up to | 2000 mL per day if this amount is not contraindicatedby the patient’s condition or disease process. |
The nurseencourages the patient to take | deep, diaphragmaticbreaths. The amount and consistency of sputum is monitored. |
Review the signs and symptoms of possible adverse reactions and impaired respiratory function,including the changes in | cough, color, and amount of sputum ,shortness of breath, or difficulty breathing, and stresses the need to notify the pcp at once should any of this occur |
Second-generation antihistamines are selective for | peripheral H1 receptors and, as a group, are less sedating. |
Second-Generation Antihistamines | Loratadine |
Dryness of the mouth,nose, and throat may occur when antihistamines aretaken. The nurse offers | he patient frequent sips of wateror ice chips to relieve these symptoms. Sugarless gum orsugarless hard candy may also relieve these symptoms. |
If gastric upset occurs, | take this drug with food or meals |
Use of oral decongestants may result in the fol-lowing adverse reactions | • Tachycardia and other cardiac arrhythmias• Nervousness, restlessness, insomnia• Blurred vision• Nausea and vomiting |
When a decongestant is taken with MAOIs the effect of the interaction is | Severe headache, hyperten-sion, and possiblyhypertensive crisis |
Nasal decongestant- As part of the preadministration assessment, the nurseassesses the patient’s | Blood pressure, pulse, and level ofcongestion before administering a decongestant. |
• Nasal burning and stinging may occur with the | topicaldecongestants. This effect usually disappears with use. |
If burning or stinging becomes severe | discontinue useand discuss this problem with the primary health careprovider, who may prescribe or recommend another drug. |