Author Question: The community nurse explains to a group of clients that taking combination drugs for a cold can be ... (Read 29 times)

danielfitts88 · **on:** Jul 23, 2018

The community nurse explains to a group of clients that taking combination drugs for a cold can be dangerous and cites several examples, such as:

Standard Text: Select all that apply.
1. an older male taking a cold medication with chlorpheniramine and phenylephrine (Actifed Cold and Allergy) for congestion.
2. a client with chronic obstructive pulmonary disease (COPD) taking a cold medication containing triprolidine and pseudoephedrine (Actifed Plus) for seasonal allergies.
3. a client with liver disease taking a medication containing diphenhydramine and acetaminophen (Tylenol PM).
4. a young adult with sinusitis taking a medication containing chlorpheniramine and phenylephrine (Sudafed Sinus and Allergy).
5. a middle-aged client with a cough taking a medication containing diphenhydramine and phenylephrine (Benadryl Allergy and Cold caplets).

Question 2

A client asks the nurse why the physician prescribed an oral rather than an intranasal decongestant. The nurse responds:

Standard Text: Select all that apply.
1. Intranasal decongestants can worsen congestion once the effects of the drug wear off.
2. You will need medication for the length of the allergy season, but intranasal decongestants shouldn't be taken for longer than 5 days.
3. Oral decongestants take less time to alleviate symptoms.
4. Oral decongestants are more effective at relieving severe congestion.
5. Oral decongestants carry a lower risk of systemic adverse effects.

Eazy416 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 1,2,3
Rationale 1: Chlorpheniramine can cause urinary retention in older males with enlarged prostate.
Rationale 2: Pseudoephedrine can cause bronchospasm in a client with COPD.
Rationale 3: Acetaminophen should be used cautiously in clients with liver disease.
Rationale 4: This client should not have any difficulty with this combination drug.
Rationale 5: This combination would not pose a problem for this client.
Global Rationale: Consuming combination products without appropriate symptoms can increase the risk of unnecessary adverse effects. It is usually better to take only the drugs needed to treat specific symptoms rather than a combination product. Chlorpheniramine can cause urinary retention in older males with enlarged prostate. Pseudoephedrine can cause bronchospasm in a client with COPD. Acetaminophen should be used cautiously in clients with liver disease.

Answer to Question 2

Correct Answer: 1,2
Rationale 1: Prolonged use of intranasal decongestants causes hypersecretion of mucus and worsening nasal congestion once the drug effects wear off.
Rationale 2: Because of the possibility of rebound congestion, the client would not be able to use intranasal decongestant longer than 5 days, which might not be long enough to control symptoms.
Rationale 3: Oral decongestants take longer than intranasal decongestants to alleviate symptoms.
Rationale 4: Oral decongestants are less effective than intranasal decongestants at relieving severe congestion.
Rationale 5: Oral decongestants carry a greater risk for systemic adverse effects such as high blood pressure, insomnia, and anxiety.
Global Rationale: The most serious, limiting adverse effect of the intranasal preparations is rebound congestion. In almost all patients, prolonged use causes hypersecretion of mucus and worsening nasal congestion once the drug effects wear off. This leads to a cycle of increased drug use as the condition worsens to obtain the desired effect from these drugs. Because of this rebound congestion, intranasal sympathomimetics should be used for no longer than 3 to 5 days. When administered PO, sympathomimetics do not produce rebound congestion. Their onset of action by this route, however, is much slower than when administered intranasally, and they are less effective at relieving severe congestion. They carry a greater risk for systemic adverse effects.