Chapter 54 Drugs Acting on the Upper Respiratory Tract

Chapter 54  Drugs Acting on the Upper Respiratory Tract

Complete Chapter Questions And Answers
 

Sample Questions

1.
A patient comes to the clinic with symptoms as seen in a cold. What group of upper respiratory drugs causes local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow?
A)
Antitussives
B)
Decongestants
C)
Expectorants
D)
Mucolytics
Ans:
B

Feedback:

Decongestants cause local vasoconstriction that decreases blood flow to irritated and dilated capillaries of the mucous membranes lining the nasal passages and sinus cavities. This vasoconstriction leads to a shrinking of swollen membranes and opens clogged nasal passages promoting drainage of secretions and improved air flow. Antitussives either work directly on the medullary cough center of the brain or act as a local anesthetic on the respiratory passages blocking the effectiveness of the stretch receptors that stimulate a cough reflex. Expectorants liquefy lower respiratory tract secretions, reducing the viscosity of the secretions and so making it easier to cough them up. Mucolytics break down mucus to aid a person in coughing up thick tenacious secretions by separating cells that hold mucous material together.

2.
What would be the nurse’s best response if a patient calls the clinic and reports that he has had a persistent cough for 2 weeks and asks the nurse for a recommendation for a cough medicine?
A)
“Look for dextromethorphan as an ingredient in any OTC cough preparation.”
B)
“The doctor could order an antihistamine, which might dry up your secretions and stop the cough.”
C)
“You should come to the clinic to be evaluated. A cough that lasts that long might be an indication of an underlying medical problem.”
D)
“Drink a lot of fluids and take aspirin, which should reduce the irritation in your throat.”
Ans:
C

Feedback:

A cough that has persisted for 2 weeks could be indicative of an underlying medical condition that should be addressed before treating the cough. The patient should be asked to come in for an evaluation. Dextromethorphan could help stop the cough, but suppressing the cough might not be in the patient’s best interest. Drying the mucosa with an antihistamine could aggravate the cough. Aspirin would not be indicated for relieving throat irritation.

3.
The nurse is caring for a patient who is receiving acetylcysteine (Mucomyst) by face mask. What would be an appropriate nursing diagnosis?
A)
Impaired swallowing
B)
Risk for impaired skin integrity
C)
Risk for falls
D)
Sleep deprivation
Ans:
B

Feedback:

A patient receiving acetylcysteine by face mask should have the residue wiped off the face mask and her face with plain water to prevent skin breakdown. The appropriate nursing diagnosis would be risk for impaired skin integrity. Acetylcysteine does not cause impaired swallowing, produce any CNS effects that could increase the risk for falls, or impair the patient’s ability to sleep.

4.
A nurse is caring for a 15-year-old patient with cystic fibrosis who has been prescribed dornase alfa (Pulmozyme) to relieve the buildup of secretions and keep airways open and functioning longer. What will the nurse instruct the patient to do concerning the use of this drug?
A)
Use in home nebulizer up to four times a day if needed.
B)
Stop all other medications while using the drug.
C)
Store the drug in the refrigerator, protected from light.
D)
Expect a severe headache after each use.
Ans:
C

Feedback:

Patients using dornase alfa should be cautioned to store the drug in the refrigerator, protected from light. Heat and light can cause the drug to break down and can decrease its therapeutic value. The drug should only be used up to two times a day and the patient should continue all other medications while using it. Dornase alfa is only a palliative therapy that improves respiratory symptoms. A severe headache is not associated with this drug.

5.
A nurse in a three drops with respiratory problems has received orders for four patients. What medication order will the nurse question?
A)
Tetrahydrozoline (Tyzine) three drops in each nostril for an 8-year-old child
B)
Hydrocodone (Hycodan) 10 mg PO for a 5-year-old child
C)
Pseudoephedrine (Dorcol) 15 mg PO for a 2-year-old child
D)
Diphenhydramine (Benadryl) 5 mg/kg IM for a 10-year-old child
Ans:
B

Feedback:

The nurse should question the order for hydrocodone. The ordered dose, 10 mg, is an adult dose and should not be given to a 5-year-old. Patients from 2 to 12 years of age should be given between 1.25 and 5 mg/dose. The other medications are all correct dosages for the age of the child for whom they were prescribed.