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
Prednisone is a corticosteroid medication commonly used to treat asthma and other inflammatory conditions. When taken for a prolonged period at higher doses, it can suppress the body's natural production of cortisol, a hormone produced by the adrenal glands. Abruptly stopping prednisone after long-term use can lead to adrenocortical insufficiency, also known as adrenal insufficiency or adrenal crisis.
Adrenocortical insufficiency occurs because the body's adrenal glands need time to resume normal cortisol production after being suppressed by prednisone. Gradually reducing the dose of prednisone allows the adrenal glands to gradually increase their cortisol production, minimizing the risk of adrenal insufficiency.
Rebound pulmonary congestion, hyperglycemia, and severe dehydration are not specific adverse effects associated with discontinuing prednisone. However, it is important for clients who have been taking prednisone to follow their healthcare provider's instructions regarding the tapering schedule and any potential risks or side effects.
Correct Answer is A
Explanation
Nasal glucocorticoids, also known as intranasal corticosteroids, are considered the most effective and recommended first-line treatment for nasal congestion caused by allergic rhinitis or non-allergic rhinitis. They work by reducing inflammation in the nasal passages, relieving congestion, and improving other symptoms such as itching, sneezing, and runny nose.
Leukotriene modifiers, decongestants, and antihistamines can also be used to manage nasal congestion, but they are generally considered second-line options or adjunct therapies.
Decongestants provide temporary relief by constricting blood vessels in the nasal passages, while antihistamines help with symptoms related to allergies. Leukotriene modifiers are primarily used for managing asthma and are not typically the first choice for nasal congestion alone.
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