A nurse is caring for a client who is prescribed diphenhydramine to relieve pruritus. The client asks the nurse how he can minimize the daytime sedation he is experiencing. Which of the following responses should the nurse give?
"Distribute the doses evenly throughout the day!"
"Gradually decrease the dose once tolerance to the effect is reached."
"Take the medication with meals."
"Take most of the daily dose at bedtime."
The Correct Answer is D
Diphenhydramine is an antihistamine medication that can cause sedation as a side effect. Taking most of the daily dose at bedtime can help minimize daytime sedation. By taking the medication closer to bedtime, the sedative effects are more likely to occur during sleep, reducing the impact of sedation during waking hours.
The other options mentioned are not effective strategies to minimize daytime sedation caused by diphenhydramine:
A. "Distribute the doses evenly throughout the day": This approach may lead to a consistent level of sedation throughout the day and may not effectively minimize daytime sedation.
B. "Gradually decrease the dose once tolerance to the effect is reached": Gradually decreasing the dose of diphenhydramine is not a recommended strategy for minimizing daytime sedation. It is important to follow the prescribed dose and consult with a healthcare provider before making any changes to the medication regimen.
C. "Take the medication with meals": Taking diphenhydramine with meals may help reduce the risk of stomach upset but does not directly address the issue of daytime sedation.
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Correct Answer is D
Explanation
Dry mouth is a common side effect of diphenhydramine, which is an antihistamine medication commonly used to relieve symptoms of allergies, including itching and rash. Chewing on sugarless gum or sucking on hard, sour candies can help stimulate saliva production and alleviate the discomfort of dry mouth.

A. "Administer the medication with food": While taking diphenhydramine with food may help reduce the risk of stomach upset, it does not directly address the dry mouth side effect.
B. "Discontinue the medication and notify your provider": Discontinuing the medication without consulting the healthcare provider is not recommended unless specifically instructed to do so. Dry mouth is a common side effect of diphenhydramine and can be managed with supportive measures.
C. "Place a humidifier at your bedside every evening": While using a humidifier can help add moisture to the air and potentially alleviate dryness in the environment, it is not a specific instruction for managing dry mouth caused by diphenhydramine.
Correct Answer is C
Explanation
Rebound congestion, also known as rhinitis medicamentosa, is a common adverse effect associated with the prolonged use of nasal decongestants. It occurs when the blood vessels in the nasal passages become dependent on the medication for constriction and lose their ability to regulate naturally. As a result, when the medication wears off, the nasal congestion worsens, leading to a cycle of continued use and worsening symptoms.
In this scenario, the patient's complaint of worsening nasal congestion despite using oxymetazoline every 2 to 4 hours for the past 5 days suggests the possibility of rebound congestion. The nurse should explain to the patient that prolonged or frequent use of nasal decongestants can lead to this effect and recommend gradually tapering off the medication use or discontinuing it altogether. The nurse may also suggest alternative non-medication strategies for managing nasal congestion, such as saline nasal sprays or steam inhalation.
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