When caring for a client with an upper respiratory infection (URI), the nurse is notified the client is taking guaifenesin (Mucinex). What is the mechanism of action of guaifenesin (Mucinex)?
Stimulate alpha-adrenergic receptors, thus producing vascular constriction of capillaries in nasal mucosa
Compete with histamine for receptor sites, thus preventing a histamine response and overall congestion.
Treat allergic rhinitis and prevent motion sickness.
Loosen bronchial secretion to assist in elimination.
The Correct Answer is D
A. Stimulate alpha-adrenergic receptors, thus producing vascular constriction of capillaries in nasal mucosa: This describes the action of decongestants, not guaifenesin. Guaifenesin does not work by constricting blood vessels; rather, its primary function is to help manage mucus production.
B. Compete with histamine for receptor sites, thus preventing a histamine response and overall congestion: This mechanism is associated with antihistamines, which are used to relieve symptoms of allergic reactions, not with guaifenesin. Guaifenesin does not block histamine but focuses on mucus management.
C. Treat allergic rhinitis and prevent motion sickness: While these are common uses for antihistamines, they do not apply to guaifenesin. Guaifenesin is primarily an expectorant and is not indicated for treating allergic rhinitis or motion sickness.
D. Loosen bronchial secretion to assist in elimination: Guaifenesin acts as an expectorant, promoting the clearance of mucus from the airways by loosening bronchial secretions. This facilitates easier expectoration of mucus, helping to relieve chest congestion associated with upper respiratory infections.
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Correct Answer is C
Explanation
A) Administer albuterol via inhalation device to the client: This task cannot be delegated to the unlicensed assistive personnel (UAP). Administering medications, especially inhaled bronchodilators like albuterol, requires a licensed nurse to ensure proper technique, monitor the client for adverse effects, and assess the effectiveness of the treatment.
B) Performing initial respiratory assessment to determine baseline respiratory rate: This task also cannot be delegated to the UAP. Assessing respiratory status, including determining baseline respiratory rate and identifying any abnormalities, requires critical thinking and clinical judgment that a nurse must perform.
C) Assist the client with oral hygiene following inhaled corticosteroid administration by the nurse: This task can be delegated to the UAP. Assisting with oral hygiene is within the scope of practice for UAPs, and it is essential after administering inhaled corticosteroids to help prevent oral thrush and maintain oral health.
D) Assess the client's lung sounds to determine if wheezing is present: This task cannot be delegated to the UAP. Assessing lung sounds is a critical nursing assessment that requires the knowledge and skills of a licensed nurse to interpret findings and make clinical decisions based on the assessment.
Correct Answer is ["C","E"]
Explanation
A. This medication (Benadryl) targets H2 receptors to alleviate symptoms: This statement is incorrect. Diphenhydramine is an H1 receptor antagonist, not an H2 antagonist. H1 receptors are primarily involved in allergic reactions, whereas H2 receptors are related to gastric acid secretion.
B. Take this medication on an empty stomach before breakfast. Drowsiness is a common side effect of diphenhydramine (Benadryl): While drowsiness is indeed a common side effect, taking diphenhydramine on an empty stomach is not necessarily required and may lead to gastrointestinal discomfort. It can be taken with food if preferred.
C. Avoid CNS depressants while taking diphenhydramine (Benadryl): This is an important teaching point. Diphenhydramine can cause sedation, and the use of other CNS depressants (like alcohol or sedatives) can enhance this effect, increasing the risk of excessive drowsiness or other complications.
D. This medication is a 2nd generation antihistamine: This statement is incorrect. Diphenhydramine is actually a first-generation antihistamine. First-generation antihistamines tend to cause more sedation and other side effects compared to second-generation antihistamines, which are less sedating.
E. Paradoxical reactions can be seen with this medication: This is true. In some individuals, particularly children, diphenhydramine can cause paradoxical reactions, such as increased excitability or hyperactivity, rather than the expected sedation. This is an important consideration to discuss with clients.