A patient complains of worsening nasal congestion despite the use of oxymetazoline (Afrin) nasal spray every 2 to 4 hours for the past 5 days. The nurse's response is based on the knowledge that
Oxymetazoline should be administered in an hourly regimen for severe congestion.
Oxymetazoline is not an effective nasal decongestant
Sustained use of nasal decongestants over several days may result in rebound congestion
The patient is probably displaying an idiosyncratic reaction to oxymetazoline
The Correct Answer is C
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Acetaminophen is generally considered safe and well-tolerated when used appropriately. However, it is primarily metabolized by the liver, and in cases of severe hepatic impairment or liver failure, the metabolism of acetaminophen can be significantly impaired. This can lead to the accumulation of toxic metabolites, which can cause further liver damage and potentially result in hepatotoxicity.
Hypertension, gallbladder disease, and tachyarrhythmias are not typically considered contraindications for the use of acetaminophen. However, it is important to consider any potential interactions or precautions when using acetaminophen in patients with these conditions, and consulting with a healthcare provider is recommended to ensure the safe and appropriate use of the medication.
Correct Answer is D
Explanation
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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