Author Question: An older male client with several chronic conditions is using pseudoephedrine (Sudafed) for cold ... (Read 65 times)

dejastew · **on:** Jul 23, 2018

An older male client with several chronic conditions is using pseudoephedrine (Sudafed) for cold symptoms. Which adverse effect does the nurse teach the client to report to the physician?

1. Increased coughing
2. Irritated, crusty nares
3. Thickening and color change of nasal drainage
4. Decreased urinary stream

Question 2

The nurse is teaching a group about the use of cough medications. Which preparation should be used for nonproductive coughs?

1. Guaifenesin (Robitussin GF)
2. Acetylcysteine (Mucomyst)
3. Dextromethorphan (Delsym)
4. Guaifenesin (Mucinex)

jesse.fleming · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 4
Rationale 1: Decongestants do not affect coughing.
Rationale 2: Earlier irritation often makes the outer opening to the nares red and sore after several days of a cold. The problem will gradually improve.
Rationale 3: Nasal drainage often evolves from clear to colored in the common cold.
Rationale 4: Pseudoephedrine can cause diminished urinary outflow in clients who have prostate enlargement.
Global Rationale: Pseudoephedrine should not be used by patients with severe HTN, severe coronary artery disease, or hypersensitivity to this drug, or by those who take monoamine oxidase inhibitor (MAOI) drugs. Alpha-adrenergic agonists should be used with caution in patients with prostatic enlargement, because these drugs increase smooth muscle activity in the prostate gland and may diminish urinary outflow. Decongestants do not affect coughing. Earlier irritation often makes the outer opening to the nares red and sore after several days of a cold. The problem will gradually improve. Nasal drainage often evolves from clear to colored in the common cold.

Answer to Question 2

Correct Answer: 3
Rationale 1: Robitussin GF contains guaifenesin, which is an expectorant.
Rationale 2: Mucomyst contains acetlycysteine, which is a mucolytic.
Rationale 3: Delsym contains dextromethorphan, which is appropriate for dry coughs.
Rationale 4: Mucinex contains guaifenesin, which is an expectorant.
Global Rationale: Although used for over 50 years to treat cough, controlled studies examining the effectiveness of dextromethorphan have given mixed results. Its present status is that the FDA considers it a safe and effective cough suppressant when used at recommended doses. It appears to be more effective at reducing nonproductive cough due to chronic throat irritation from tobacco use or emphysema rather than acute cough due to colds. Guaifenesin is an expectorant and acetlycysteine is a mucolytic.