A nurse is preparing to administer acetylcysteine (Mucomyst) to a client with excessive respiratory secretions. Which of the following statements are correct regarding acetylcysteine (Mucomyst) (Select All that Apply.)
alternative usage includes being the reversal agent for acetaminophen overdoses.
This medication should not be used for clients with productive coughs.
This medication has a foul smell resembling "rotten eggs"
This medication can be utilized in client's with cystic fibrosis. This medication falls under the classification of "mucoyltic".
This medication has anticholinergic properties and side effects
Correct Answer : A,C,D
A) Alternative usage includes being the reversal agent for acetaminophen overdoses: Acetylcysteine is indeed used as an antidote for acetaminophen toxicity. It helps replenish glutathione levels in the liver, thus protecting it from damage caused by the overdose. This is a well-established use of the medication.
B) This medication should not be used for clients with productive coughs: This statement is not correct. Acetylcysteine is used to help thin and loosen mucus, making it easier to expel from the lungs. It can be beneficial for clients with productive coughs, as it aids in reducing excessive respiratory secretions.
C) This medication has a foul smell resembling "rotten eggs": Acetylcysteine has a characteristic odor that is often described as similar to rotten eggs due to the presence of sulfur in its chemical structure. This can be an important consideration for patients when administering the medication.
D) This medication can be utilized in clients with cystic fibrosis. This medication falls under the classification of "mucolytic": Acetylcysteine is classified as a mucolytic agent, making it useful for patients with conditions like cystic fibrosis, where thick mucus production is a significant issue. It helps to decrease the viscosity of secretions, facilitating easier clearance.
E) This medication has anticholinergic properties and side effects: This statement is incorrect. Acetylcysteine does not possess anticholinergic properties. Anticholinergic medications typically reduce secretions and are used for different indications, whereas acetylcysteine serves to increase mucus clearance, not decrease it.
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Correct Answer is A
Explanation
A) Beta-Blockers: The use of beta-blockers is a direct contraindication to albuterol administration. Albuterol is a beta-agonist that works by stimulating beta-2 adrenergic receptors to cause bronchodilation. Beta-blockers can antagonize this effect, potentially leading to increased bronchospasm and worsening asthma symptoms. Therefore, if a client is on beta-blockers, caution must be exercised when administering albuterol.
B) Anticholinergics: Anticholinergics, such as ipratropium, are often used in conjunction with beta-agonists like albuterol to provide synergistic effects in managing asthma. There are no direct contraindications between anticholinergics and albuterol, and they can be used together safely to improve bronchial dilation and mucus clearance.
C) Antihistamines: Antihistamines are not contraindicated with albuterol. While they may be used for managing allergic reactions and symptoms, they do not interfere with the action of beta-agonists. Therefore, a client taking antihistamines can still safely receive albuterol for acute asthma attacks.
D) Glucocorticoids: Glucocorticoids, such as prednisone, are often used in asthma management for their anti-inflammatory properties. They are not contraindicated with albuterol; in fact, they are commonly used together in asthma treatment plans. Glucocorticoids help to reduce airway inflammation, while albuterol provides quick relief from bronchospasm.
Correct Answer is A
Explanation
A) Liver injury: Zafirlukast (Accolate) has been associated with the risk of liver injury. It is important for clients to be informed about this potential adverse effect, as it may require monitoring of liver function tests during treatment. Symptoms of liver injury, such as jaundice, dark urine, or severe fatigue, should prompt clients to seek medical attention.
B) Bradycardia: Bradycardia is not a commonly associated adverse effect of zafirlukast. This medication primarily works as a leukotriene receptor antagonist and does not typically affect heart rate significantly. Clients should be aware of other more relevant side effects rather than bradycardia.
C) Renal failure: Renal failure is not a known adverse effect of zafirlukast. While kidney function should always be monitored in patients taking various medications, zafirlukast specifically does not have a direct association with renal failure.
D) Bronchoconstriction: While bronchoconstriction is a concern in asthma management, zafirlukast is designed to prevent bronchoconstriction by blocking leukotriene receptors. Therefore, it is not an adverse effect of the medication. In fact, its purpose is to help reduce the incidence of bronchoconstriction and improve asthma control.