Summary
Summary NUR 206 Exam 3 Study Guide
- Course
- NUR 206
- Institution
- Carrington College
This is a comprehensive and detailed summary on Exam 3 for Nur 206. An Essential Study Resource!!
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NUR 206 Exam 3 Study GuideAntihistamines: Short-acting (histamine agonists compete with histamine receptors)
Example: Diphenhydramine (Benadryl)
Purpose: Treatment of allergies, runny nose, inflamed & swollen nasal mucosa, vertigo, motion sickness, insomnia & cough
Therapeutic Action: ↑HR, ↓ dilation of blood vessels, ↓ salivary/gastric/lacrimal/bronchial secretions (dry secretions)
Major side effects: Drowsiness, hypotension, palpitations, vertigo, dizziness, dryness of mouth/nose/throat, urinary retention,
tinnitus, headache, restlessness, N/V, diarrhea, constipation
Contraindications: Pregnancy, lower respiratory diseases (pneumonia), glaucoma, cardiac disease, kidney disease, HTN,
bronchial asthma, COPD, PUD, seizure disorders & BPH
Pregnancy category: B
Nursing Implications
o Assessment: Assess for allergies & pregnancy.
o Patient teaching: Report excessive sedation, confusion, hypotension; avoid driving or operating heavy machinery;
advise against ETOH or other CNS depressants. Avoid if possible, during pregnancy or only take it if absolutely
necessary.
Nonsedating antihistamines: Longer acting (does not work on CNS so it does not make the patient drowsy)
Examples: Loratadine (Claritin), cetirizine (Zyrtec), & fexofenadine (Allegra)
Decongestants: Oral (slow-acting, lasting effect) vs topical (fast-acting, short effect)
Examples: Pseudoephedrine (Sudafed), ephedrine
Purpose: Treatment of nasal congestion (allergies, URIs)
Therapeutic Action: Shrink engorged nasal mucous membranes & relieve nasal stuffiness
Major side effects: Nervousness, insomnia, palpitations, tremors, HTN, dizziness
Adverse effects: palpitations, nervousness & tremors
Contraindications: Glaucoma, HTN, uncontrolled cardiovascular disease, diabetes, hyperthyroidism
Pregnancy category: B
Patient teaching: Report fever, cough, or other symptoms lasting longer than 1 week; avoid caffeine; avoid taking nasal
decongestants for more than 2 days as this leads to rebound congestion
Antitussives: Cough suppressants
Example: Dextromethorphan (Robitussin DM)
Purpose: Suppress the cough reflex through the cough center in the medulla
Major side effects: Dizziness, headache, sedation, N/V, constipation, pruritis, nasal congestion, & dry mouth
Contraindications: Drug allergy; opioid antitussives can cause dependency & ↑ risk for respiratory depression
Pregnancy category: C
Nursing Implications
o Assessment: Assess for allergies; respiratory & cough assessment
o Patient teaching: Report fever, cough, or other symptoms lasting longer than 1 week; report persistent headache, rash;
for nonproductive cough only
Expectorants
Example: Guaifenesin (Mucinex)
Purpose: Aid in the removal of mucus. Helps to treat bronchitis with a productive cough.
Therapeutic Action: Reduce viscosity of secretions & thin mucus
Major side effects: N/V, gastric irritation
Pregnancy category: C
Contraindications: Drug allergy
o Assessment: Respiratory & cough assessment; caution in older adults or patients with asthma/respiratory insufficiency
o Patient teaching: Report fever, cough, or other symptoms lasting longer than 1 week; increase fluid intake
Albuterol patient teaching
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, It is a rescue inhaler, if using more than twice a week call the physician; avoid caffeine (increases heart rate)
Inhaler use
Use bronchodilator first
Encourage the client to use a spacer device when using inhalers to ensure successful administration of the inhaled meds.
Ensure the client secures the inhaler mouthpiece with his/her lips while pressing on top of the canister.
After inhaling the medication from the inhaler slowly, teach the client to hold their breath for a few seconds then exhaling
slowly.
Wait 2-5 minutes between doses (puffs)
Rinse mouth after inhaler use to prevent oral yeast infections like Candidiasis (white patches inside the mouth).
Clean all washable parts of the inhaler daily.
Which group of “cold medicine” causes rebound congestion?
nasal decongestants
How do nasal steroids work to help the congested person?
Nasal steroids stops the local inflammatory response decreasing congestion and swelling
When are antitussives beneficial vs. harmful to the patient?
Beneficial when patient needs to avoid coughing: abdominal surgery or injury (minimize risk of dehiscence)
Opioid antitussives such as codeine & hydrocodone may potentiate the effects of other opioids, general anesthetics,
tranquilizers, sedatives, hypnotics, tricyclic antidepressants, ETOH, & other CNS depressants.
What is the problem in chronic bronchitis vs. emphysema vs. bronchial asthma?
Chronic bronchitis: chronic inflammation of the bronchi
Emphysema: damage to alveolar tissue resulting in permanent air exchange problems
Bronchial asthma: airway narrowing of bronchi & bronchioles
Beta-adrenergic agonists: (AKA beta-agonists or adrenergic agonists) can be short- or long-acting
Examples: Albuterol, salmeterol
Purpose: Relaxes the airway and reduces airway constriction to restore airflow
Therapeutic Action: Maintenance of asthma & COPD
Major side effects: Insomnia, restlessness, anorexia, cardiac stimulation, hyperglycemia, tremor, & vascular headache
Contraindications: Uncontrolled HTN, dysrhythmias, and high risk of stroke
Interactions: MAOIs, & diabetics (can raise blood glucose levels)
Anticholinergics:
Purpose: Block cholinergic receptors from binding with substances that can cause bronchoconstriction and increase secretions
Therapeutic Action: blocks cholinergic receptors, thus preventing the binding of cholinergic substances that cause
bronchoconstriction & increase nasal secretions
Major side effects: Dry mouth or throat, nasal congestion, heart palpitations, GI distress
Contraindications: Glaucoma, BPH, allergy to atropine
Examples: ipratropium (Atrovent), tiotropium (Spiriva)
Interactions: Additive effects w/ other anticholinergics
Know the benefits vs. risks of giving aspirin and/or NSAIDs as antipyretics, analgesics, and anti-inflammatories.
Aspirin: Affects clot formation so initiate bleeding precautions, do not give under 18 years old
Adverse effects: GI bleed, hepatic & renal toxicity, tinnitus, N/V, anorexia, sensitivity reactions, hearing loss
Naproxen or Ibuprofen adverse effects: GI ulceration, bleeding, and perforation → abdominal pain
Know the purpose of misoprostol (Cytotec) as related to NSAIDs.
Aids in the prevention of gastric ulcers and GI bleeding when in combination with other NSAIDs.
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