Roach 32,33
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| Most antitussives depress the cough center located in the | medulla and are called centrally-acting drugs.
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| Codeine and dextromethorphan are examples of | centrally-acting antitussives.
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| One antitussive acts peripherally by anesthetizingstretch receptors in the respiratory passages, thereby | decreasing coughing.
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| Benzonatate (Tessalon) is the | peripherally-acting antitussive.
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| acetylcysteine | Stomatitis, nausea, vom-iting, fever, drowsiness,bronchospasm, irritationof the trachea andbronchi
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| Antitussives are contraindicated in patients with | knownhypersensitivity to the drugs.
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| The opioid antitussives(those with codeine) are contraindicated in | prematureinfants or during labor when delivery of a premature infant isanticipated.
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| During the preadministrationassessment, the nurse documents the type | of cough (pro-ductive, nonproductive) and describes the color and amount of any sputum present.
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| 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.
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| 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.
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| 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.
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| The nurse also notes and records whether the coughinterrupts | sleep and whether it causes pain in the chestor other parts of the body.
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| PATIENT RECEIVING A MUCOLYTIC OR AN EXPECTORANT After administering the drug, the nurse notes any increase in | sputum or change in consistency
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| The nursedocuments, on the patient’s chart, a description of | the sputum raised.
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| Patients with thick, tenacious mucus may have | difficulty breathing.
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| 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.
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| 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.
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| hese evaluations aid the primaryhealth care provider in determining | the effectiveness of therapy.
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| 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.
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| The nurseencourages the patient to take | deep, diaphragmaticbreaths. The amount and consistency of sputum is monitored.
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| 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
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| Second-generation antihistamines are selective for | peripheral H1 receptors and, as a group, are less sedating.
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| Second-Generation Antihistamines | Loratadine
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| 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.
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| If gastric upset occurs, | take this drug with food or meals
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| 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
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| When a decongestant is taken with MAOIs the effect of the interaction is | Severe headache, hyperten-sion, and possiblyhypertensive crisis
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| Nasal decongestant- As part of the preadministration assessment, the nurseassesses the patient’s | Blood pressure, pulse, and level ofcongestion before administering a decongestant.
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| • Nasal burning and stinging may occur with the | topicaldecongestants. This effect usually disappears with use.
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| If burning or stinging becomes severe | discontinue useand discuss this problem with the primary health careprovider, who may prescribe or recommend another drug.
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