NR 293 Exam 2 Latest Pre Questions
With Already Verified Answers.
Common cold - Answer Most caused by viral infection: rhinovirus or influenza
-Virus invades tissues causing upper respiratory infection
Treatment for common cold - Answer Symptomatic only, not curative
"Empiric therapy"
Empiric therapy - Answer Treatment based on experience usually w/o adequate data to support its use
Antihistamines - Answer Compete with histamine for specific receptor sites
Two histamine receptors: H1 and H2
H1 (histamine 1) - Answer Commonly referred to as antihistamines
Ex: fexofenadine (allegra), Ioratadine (claritin), diphenhydramine (benedryl)
H2 (histamine 2) - Answer Used to reduce gastric acid in peptic ulcer disease
Properties of antihistamines - Answer Antihistaminic
Anticholinergic
Sedative
Antihistamine MOA - Answer Block action of histamine at H1 receptor sites, preventing adverse
consequences of histamine stimulation
-Cannot push histamine off receptor if already bound
-More effective in preventing actions of histamine rather than reversing them (should be given early)
Adverse consequences of histamine stimulation - Answer Vasodilation
,Increased GI and respiratory secretions
Increased capillary permeability
Antihistamine uses - Answer Management of:
-Nasal allergies
-Seasonal or perennial allergic rhinitis (hay fever)
-Allergic reactions
-Motion sickness
-Parkinson's disease
-Sleep disorders
Relieve symptoms of common cold, sneezing, runny nose
Adverse effects of antihistamines - Answer Anticholinergic (drying) effects are most common
-Dry mouth
-Difficulty urinating
-Constipation
-Changes in vision
Also drowsiness: mild to deep sleep
Contraindications of antihistamines - Answer Acute asthma attacks
Lower respiratory diseases (pneumonia)
Traditional antihistamines - Answer Peripherally and centrally acting
More effective than non-sedating drugs
Ex: Diphenhydramine, bronpheniramine, chlropheniramine, dimenhydrinate, meclizine, proethazine
Non-sedating antihistamines - Answer Peripherally acting
-Eliminate unwanted ASE (sedation)
-Work peripherally to block histamine causing fewer CNS adverse effects
,-Longer duration of action (increases compliance)
Ex: Fexofenadine (allegra), Ioratadine (claritin), cetirizine (zyrtec)
Antihistamine nursing implications - Answer Assess condition and drug allergies
Report excessive sedation, confusion, hypotension
Avoid driving, alcohol, CNS depressants
Best tolerated with meals
Frequent mouth care, chew gum, suck on hard candy for dry mouth
Monitor for intended therapeutic effects
Use antihistamine with caution if: - Answer Increased intraocular pressure
Cardiac or renal disease
Hypertension
Asthma
COPD
Peptic ulcer disease
BPH
Pregnancy
Adrenergics: Sympathomimetics - Answer Used for nasal congestion
-Constrict small blood vessels, nasal secretions in swollen mucous membranes are better able to drain
Sympathomimetics adverse effects - Answer SNS stimulation
Palpitations
Insomnia
Nervousness
Tremors
Corticosteroids: Topical, intranasal steroids - Answer Used for nasal decongestion
, -Anti-inflammatory effect, decreasing congestion
Ex: fluticasone (flonase), budesonide (rhinocort)
Corticosteroids: Topical, intranasal steroids adverse effects - Answer Local mucosal dryness and
irritation
Oral adrenergic decongestants - Answer -Delayed onset
-Prolonged decongestant
-Less potent effect than topical
-No rebound congestion
Ex: pseudoephedrine (sudafed)
Topical adrenergic decongestants - Answer -Prompt onset
-Potent
-Sustained use may cause rebound congestion
Nursing implications of nasal decongestants - Answer May cause hypertension, palpitations, CNS
stimulation
Assess for drug allergies
Avoid caffeine
Report fever, cough or other symptoms lasting longer than a week
Monitor for intended therapeutic effects
Cough reflex - Answer Induces coughing and expectoration
Initiated by irritation of sensory receptors in the respiratory tract
Antitussives - Answer Drugs to stop or reduce coughing
Used only for non-productive coughs
May be used in cases where coughing is harmful (post op hernia repair)
With Already Verified Answers.
Common cold - Answer Most caused by viral infection: rhinovirus or influenza
-Virus invades tissues causing upper respiratory infection
Treatment for common cold - Answer Symptomatic only, not curative
"Empiric therapy"
Empiric therapy - Answer Treatment based on experience usually w/o adequate data to support its use
Antihistamines - Answer Compete with histamine for specific receptor sites
Two histamine receptors: H1 and H2
H1 (histamine 1) - Answer Commonly referred to as antihistamines
Ex: fexofenadine (allegra), Ioratadine (claritin), diphenhydramine (benedryl)
H2 (histamine 2) - Answer Used to reduce gastric acid in peptic ulcer disease
Properties of antihistamines - Answer Antihistaminic
Anticholinergic
Sedative
Antihistamine MOA - Answer Block action of histamine at H1 receptor sites, preventing adverse
consequences of histamine stimulation
-Cannot push histamine off receptor if already bound
-More effective in preventing actions of histamine rather than reversing them (should be given early)
Adverse consequences of histamine stimulation - Answer Vasodilation
,Increased GI and respiratory secretions
Increased capillary permeability
Antihistamine uses - Answer Management of:
-Nasal allergies
-Seasonal or perennial allergic rhinitis (hay fever)
-Allergic reactions
-Motion sickness
-Parkinson's disease
-Sleep disorders
Relieve symptoms of common cold, sneezing, runny nose
Adverse effects of antihistamines - Answer Anticholinergic (drying) effects are most common
-Dry mouth
-Difficulty urinating
-Constipation
-Changes in vision
Also drowsiness: mild to deep sleep
Contraindications of antihistamines - Answer Acute asthma attacks
Lower respiratory diseases (pneumonia)
Traditional antihistamines - Answer Peripherally and centrally acting
More effective than non-sedating drugs
Ex: Diphenhydramine, bronpheniramine, chlropheniramine, dimenhydrinate, meclizine, proethazine
Non-sedating antihistamines - Answer Peripherally acting
-Eliminate unwanted ASE (sedation)
-Work peripherally to block histamine causing fewer CNS adverse effects
,-Longer duration of action (increases compliance)
Ex: Fexofenadine (allegra), Ioratadine (claritin), cetirizine (zyrtec)
Antihistamine nursing implications - Answer Assess condition and drug allergies
Report excessive sedation, confusion, hypotension
Avoid driving, alcohol, CNS depressants
Best tolerated with meals
Frequent mouth care, chew gum, suck on hard candy for dry mouth
Monitor for intended therapeutic effects
Use antihistamine with caution if: - Answer Increased intraocular pressure
Cardiac or renal disease
Hypertension
Asthma
COPD
Peptic ulcer disease
BPH
Pregnancy
Adrenergics: Sympathomimetics - Answer Used for nasal congestion
-Constrict small blood vessels, nasal secretions in swollen mucous membranes are better able to drain
Sympathomimetics adverse effects - Answer SNS stimulation
Palpitations
Insomnia
Nervousness
Tremors
Corticosteroids: Topical, intranasal steroids - Answer Used for nasal decongestion
, -Anti-inflammatory effect, decreasing congestion
Ex: fluticasone (flonase), budesonide (rhinocort)
Corticosteroids: Topical, intranasal steroids adverse effects - Answer Local mucosal dryness and
irritation
Oral adrenergic decongestants - Answer -Delayed onset
-Prolonged decongestant
-Less potent effect than topical
-No rebound congestion
Ex: pseudoephedrine (sudafed)
Topical adrenergic decongestants - Answer -Prompt onset
-Potent
-Sustained use may cause rebound congestion
Nursing implications of nasal decongestants - Answer May cause hypertension, palpitations, CNS
stimulation
Assess for drug allergies
Avoid caffeine
Report fever, cough or other symptoms lasting longer than a week
Monitor for intended therapeutic effects
Cough reflex - Answer Induces coughing and expectoration
Initiated by irritation of sensory receptors in the respiratory tract
Antitussives - Answer Drugs to stop or reduce coughing
Used only for non-productive coughs
May be used in cases where coughing is harmful (post op hernia repair)
