A patient with a history of angina asks the nurse whether it is ...

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A patient with a history of angina asks the nurse whether it is safe to use oral pseudoephedrine for allergic rhinitis. Select the nurse's best response.
 
  a. It is safe, provided you follow the instructions on the label.
  b. It is safe to use this agent if you are also using nitroglycerin.
  c. Rebound congestion is more common when a person with angina takes pseudoephedrine.
  d. These agents should not be used by patients with any form of heart disease.

Question 2

A hospitalized patient receives codeine as an antitussive. Beside cough suppression, what other assessments should the nurse make?
 
  a. Assess the heart rate for tachycardia.
  b. Observe for slowing of respirations.
  c. Check the blood pressure for hypertension.
  d. Assess for hyperalertness.

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Answer to Question 1

ANS: D
Sympathomimetics cause widespread vasoconstriction, which can be hazardous to patients with hypertension and coronary artery disease. The nurse should instruct the patient not to take these agents.
The use of these agents is unsafe in patients with hypertension and coronary artery disease because of their vasoconstrictive properties.
Rebound congestion is not a side effect specific to angina. The drug is contraindicated in patients with angina.

Answer to Question 2

ANS: B
Like other opioids, codeine can suppress respirations, therefore the patient's respiratory rate should be monitored closely for any declines in rate or depth.
The nurse should assess for bradycardia and hypotension, which are side effects of codeine.
Because the drug is a central nervous system (CNS) depressant, the nurse should assess the patient for sedation, not hyperalertness.

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