Nsg 349 Exam 3 Guide With
Complete Solution
Upper respiratory agents - ANSWER Rhinorrhea/Congestion: Intranasal
corticosteroids, antihistamines, decongestants
Cough: antitussives
how does the body respond to histamine - ANSWER - swelling and
inflammation
- adrenaline release
- bronchoconstriction
- dilation of blood vessels
- frequent heartbeat
- vessels and capillaries increase in permeability
- blood clotting
- simulation of gastric acid secretion
indications for antihistamines - ANSWER seasonal allergies, nasal allergies,
allergic reactions, motion sickness, nausea/vomiting, sleep disorders (cause
sedation)
MOA antihistamines - ANSWER competes with histamine for receptor sites
(Histamine is a cytokine that performs several functions in the body)
Blocking H1- block allergy symptoms
,Blocking H2- decrease gastric secretions
contraindications antihistamines - ANSWER allergy
adverse effects antihistamines - ANSWER sedation, dry mouth, confusion,
CNS depression
nursing implications antihistamines - ANSWER - monitor for therapeutic
response and adverse reactions
- patient education: avoid heavy machinery, do not mix with ETOH and CNS
depressants, chew sugarless gum if dry mouth
1st generation antihistamines - ANSWER older and cause sedation
(diphenhydramine (Benedryl) and promethazine)
2nd generation antihistamines - ANSWER dont cause sedation (fexofenadine
(allegra), loratadine (claritin), cetirizine (zyertec))
all antihistamines are used to treat -- and have --- effects - ANSWER allergy
symptoms; antihistamine and anticholinergic effect
side effect of anticholinergic antihistamines - ANSWER dry mouth
4 cants of anticho - ANSWER SEE (pupillary dilation), SPIT (dry mouth), PEE
(urinary retention), SHIT (constipation)
indications for decongestants and intranasal steroids - ANSWER nasal
congestion/rhinitis (cased by allergies/upper respiratory infections)
MOA decongestants and intranasal steroids - ANSWER Adrenergics: cause
vasoconstriction of arterioles that supply upper respiratory tract allowing
drainage
Intranasal steroids: decrease inflammatory response caused by foreign
,invader
contraindications decongestants and intranasal steroids - ANSWER
Adrenergics: allergy, cardiovascular disease, HTN, hyperthyroidism,
Inhaled steroids: allergy, diabetes
adverse effects decongestants and intranasal steroids - ANSWER
Adrenergics: nervousness, insomnia, palpitations, HTN, tremors
Inhaled steroids: mucosal irritation/dryness, oral thrush
nursing implications decongestants and intranasal steroids - ANSWER -
monitor for therapeutic effects and adverse effects
- report to physician if symptoms last longer than a week
- dont take before bed
function of antitussives - ANSWER suppress cough
indications for antitussives - ANSWER cough (ONLY NONPRODUCTIVE), or
when coughing can be harmful (ex. following abdominal surgery)
MOA antitussives - ANSWER Opioids: codeine and hydrocodone block cough
receptors in the medulla
Non-opioids: suppress cough reflex in the medulla
contraindications antitussives - ANSWER allergies, opioid dependency,
respiratory depression
adverse effects antitussives - ANSWER Opioids: sedation, respiratory
depression, addictive potential, constipation
Non-opioids: dizziness, drowsiness
, nursing implications antitussives - ANSWER - monitor for effects
- assess cough (dont give if there is a productive cough, mucus needs to
come out of lungs if infection)
- avoid heavy machinery
- report if symptoms last more than a week
airway obstruction can be caused by - ANSWER allergic reaction,
angioedema, physical trauma or burns, infectious process, severe asthma
attack
racemic epinephrine indications - ANSWER airway obstruction, emergency
situation
MOA racemic epinephrine - ANSWER stimulate alpha adrenergic receptors in
airway, leading to mucosal vasoconstriction and decreased subglottic edema,
stimulate beta adrenergic receptors
contraindications racemic epinephrine - ANSWER allergy
adverse effects racemic epinephrine - ANSWER insomnia, restlessness, HTN,
headache, tremor, anorexia, cardiac simulation
Complete Solution
Upper respiratory agents - ANSWER Rhinorrhea/Congestion: Intranasal
corticosteroids, antihistamines, decongestants
Cough: antitussives
how does the body respond to histamine - ANSWER - swelling and
inflammation
- adrenaline release
- bronchoconstriction
- dilation of blood vessels
- frequent heartbeat
- vessels and capillaries increase in permeability
- blood clotting
- simulation of gastric acid secretion
indications for antihistamines - ANSWER seasonal allergies, nasal allergies,
allergic reactions, motion sickness, nausea/vomiting, sleep disorders (cause
sedation)
MOA antihistamines - ANSWER competes with histamine for receptor sites
(Histamine is a cytokine that performs several functions in the body)
Blocking H1- block allergy symptoms
,Blocking H2- decrease gastric secretions
contraindications antihistamines - ANSWER allergy
adverse effects antihistamines - ANSWER sedation, dry mouth, confusion,
CNS depression
nursing implications antihistamines - ANSWER - monitor for therapeutic
response and adverse reactions
- patient education: avoid heavy machinery, do not mix with ETOH and CNS
depressants, chew sugarless gum if dry mouth
1st generation antihistamines - ANSWER older and cause sedation
(diphenhydramine (Benedryl) and promethazine)
2nd generation antihistamines - ANSWER dont cause sedation (fexofenadine
(allegra), loratadine (claritin), cetirizine (zyertec))
all antihistamines are used to treat -- and have --- effects - ANSWER allergy
symptoms; antihistamine and anticholinergic effect
side effect of anticholinergic antihistamines - ANSWER dry mouth
4 cants of anticho - ANSWER SEE (pupillary dilation), SPIT (dry mouth), PEE
(urinary retention), SHIT (constipation)
indications for decongestants and intranasal steroids - ANSWER nasal
congestion/rhinitis (cased by allergies/upper respiratory infections)
MOA decongestants and intranasal steroids - ANSWER Adrenergics: cause
vasoconstriction of arterioles that supply upper respiratory tract allowing
drainage
Intranasal steroids: decrease inflammatory response caused by foreign
,invader
contraindications decongestants and intranasal steroids - ANSWER
Adrenergics: allergy, cardiovascular disease, HTN, hyperthyroidism,
Inhaled steroids: allergy, diabetes
adverse effects decongestants and intranasal steroids - ANSWER
Adrenergics: nervousness, insomnia, palpitations, HTN, tremors
Inhaled steroids: mucosal irritation/dryness, oral thrush
nursing implications decongestants and intranasal steroids - ANSWER -
monitor for therapeutic effects and adverse effects
- report to physician if symptoms last longer than a week
- dont take before bed
function of antitussives - ANSWER suppress cough
indications for antitussives - ANSWER cough (ONLY NONPRODUCTIVE), or
when coughing can be harmful (ex. following abdominal surgery)
MOA antitussives - ANSWER Opioids: codeine and hydrocodone block cough
receptors in the medulla
Non-opioids: suppress cough reflex in the medulla
contraindications antitussives - ANSWER allergies, opioid dependency,
respiratory depression
adverse effects antitussives - ANSWER Opioids: sedation, respiratory
depression, addictive potential, constipation
Non-opioids: dizziness, drowsiness
, nursing implications antitussives - ANSWER - monitor for effects
- assess cough (dont give if there is a productive cough, mucus needs to
come out of lungs if infection)
- avoid heavy machinery
- report if symptoms last more than a week
airway obstruction can be caused by - ANSWER allergic reaction,
angioedema, physical trauma or burns, infectious process, severe asthma
attack
racemic epinephrine indications - ANSWER airway obstruction, emergency
situation
MOA racemic epinephrine - ANSWER stimulate alpha adrenergic receptors in
airway, leading to mucosal vasoconstriction and decreased subglottic edema,
stimulate beta adrenergic receptors
contraindications racemic epinephrine - ANSWER allergy
adverse effects racemic epinephrine - ANSWER insomnia, restlessness, HTN,
headache, tremor, anorexia, cardiac simulation
