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Roach 32,33

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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.
Created by: tekishahouk