Author Question: A client with a severe cough has a new order for a hydrocodone-based antitussive. Which history ... (Read 23 times)

genevieve1028 · **on:** Jul 23, 2018

A client with a severe cough has a new order for a hydrocodone-based antitussive. Which history assessment would result in changing the prescription?

1. The client has been unable to sleep for 4 nights due to coughing.
2. The client has a history of lung cancer.
3. Hydrocodone makes the client drowsy.
4. The client has a history of persistent intermittent asthma.

Question 2

The nurse is assessing a client who regularly takes an oral first-generation antihistamine for nasal allergies. Which medication order would trigger concerns about drug interaction with the antihistamine?

1. Hydrochlorothiazide, a diuretic
2. Tylenol with codeine, an opiate analgesic
3. Enoxaparin (Lovenox), an anticoagulant
4. Atenolol, an antihypertensive

kingdude89 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 4
Rationale 1: Lack of sleep due to coughing is a frequently cited reason for ordering narcotic cough medication.
Rationale 2: Hydrocodone is often ordered for clients with bronchial cancers, because the tumor triggers the cough.
Rationale 3: Hydrocodone is a narcotic, so it may cause drowsiness.
Rationale 4: A history of asthma is a concern, because hydrocodone can trigger bronchospasm.
Global Rationale: Care must be taken when using these medications in patients with asthma because bronchoconstriction may occur. Lack of sleep due to coughing is a frequently cited reason for ordering narcotic cough medication. Hydrocodone is often ordered for clients with bronchial cancers, because the tumor triggers the cough. Hydrocodone is a narcotic, so it may cause drowsiness.

Answer to Question 2

Correct Answer: 2
Rationale 1: Hydrochlorothiazide does not interact with antihistamines.
Rationale 2: First-generation antihistamines cross the bloodbrain barrier and can cause drowsiness. Codeine is a narcotic that also causes drowsiness, so there will be an additive effect.
Rationale 3: Lovenox does not interact with antihistamines.
Rationale 4: Atenolol does not interact with antihistamines.
Global Rationale: First-generation antihistamines can cause significant drowsiness as can narcotics such as codeine. The additive effect may suppress respirations. The remaining drugs do not interact adversely with antihistamines.