A client's severe asthma has necessitated the use of a long-acting beta2-agonist (LABA). Which of the client's statements suggests a need for further education?
make sure to use this each time I feel an asthma attack coming on."
"I know that these drugs can sometimes make my heart beat faster."
"I've heard that this drug sometimes gets less effective over time."
"I've heard that this drug is particularly good at preventing asthma attacks during exercise."
The Correct Answer is A
A. "Make sure to use this each time I feel an asthma attack coming on": This statement indicates a need for further education. LABAs are not intended for immediate relief of acute asthma symptoms or attacks; they are designed for long-term control and prevention of symptoms. Clients should use a short-acting beta agonist (SABA) for quick relief during an asthma attack, not a LABA.
B. "I know that these drugs can sometimes make my heart beat faster": This statement reflects an understanding of a potential side effect of LABAs. Increased heart rate is a known side effect, and it is important for clients to be aware of this possibility.
C. "I've heard that this drug sometimes gets less effective over time": This statement is accurate. Tolerance can develop with LABA use, and clients should be informed about this possibility to monitor their symptoms and report any changes to their healthcare provider.
D. "I've heard that this drug is particularly good at preventing asthma attacks during exercise": This statement is correct. LABAs can be beneficial for preventing exercise-induced bronchospasm when used as part of a regular asthma management plan, and clients should understand this use.
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Correct Answer is A
Explanation
A) Cetirizine (Zyrtec): This medication is classified as a second-generation antihistamine. Second-generation antihistamines are designed to be less sedating than first-generation agents, as they are less likely to cross the blood-brain barrier. Cetirizine effectively alleviates symptoms of allergic rhinitis by blocking histamine receptors and is commonly used due to its efficacy and reduced sedation compared to older antihistamines.
B) Chlorpheniramine (Aller-Chlor): Chlorpheniramine is a first-generation antihistamine. It tends to cause more sedation and has a higher likelihood of causing side effects such as drowsiness, dry mouth, and dizziness. First-generation antihistamines are typically less selective and can affect the central nervous system more significantly than their second-generation counterparts.
C) Diphenhydramine (Benadryl): This medication is also a first-generation antihistamine. It is well-known for its sedative effects and is often used for allergic reactions, as well as for its sleep-inducing properties. Like other first-generation antihistamines, diphenhydramine can cause significant drowsiness and other anticholinergic effects.
D) Montelukast (Singulair): Montelukast is not an antihistamine but rather a leukotriene receptor antagonist. It is used for the management of allergic rhinitis and asthma but works through a different mechanism by blocking leukotriene receptors, thereby reducing inflammation and mucus production. It is not classified as an antihistamine, either first or second generation.
Correct Answer is A
Explanation
A. Limit use of the drug to 3 days to prevent rebound nasal congestion: Oxymetazoline is a topical nasal decongestant that can lead to rebound congestion if used for more than three consecutive days. This condition, known as rhinitis medicamentosa, can worsen nasal congestion rather than alleviate it, making it crucial for clients to adhere to this guideline.
B. This drug may be used in maintenance treatment for asthma: Oxymetazoline is not indicated for the maintenance treatment of asthma. It is a nasal decongestant, primarily used for temporary relief of nasal congestion due to colds or allergies, and does not address the underlying inflammation in asthma.
C. This medication may take up to a week to see effects: In fact, oxymetazoline provides rapid relief of nasal congestion, typically within minutes of administration. Clients should expect to feel its effects much sooner rather than having to wait a week, which can lead to misuse or overuse of the medication.
D. Take this drug at bedtime because it may cause drowsiness: Oxymetazoline is not known to cause drowsiness; rather, it works as a decongestant. Patients are usually advised to use it during the day as needed, and it should not be specifically recommended for bedtime use