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
This response demonstrates that the patient understands the dosing frequency (twice a day) and the importance of taking it with a full glass of water, which aligns with the instructions provided by the nurse.
The other choices are incorrect because:
A. "Taking this medication can cause me to develop a non-productive cough.": This response is about a potential side effect of the medication, rather than showing an understanding of the dosing instructions.
B. "I will take my medication Daily with a full glass of water.": This response indicates a misunderstanding of the dosing frequency, as the prescription specifically states "BID" (twice a day) rather than "daily."
D. "The medication will have to be given by my Home Health Nurse twice a day.": This response suggests a reliance on the home health nurse to administer the medication, which contradicts the instructions for the patient to take it themselves. It shows a misunderstanding of the patient's responsibility in self-administering the medication.
Correct Answer is D
Explanation
Theophylline is a bronchodilator medication used in the treatment of asthma and other respiratory conditions. It works by relaxing the smooth muscles in the airways, allowing for easier breathing. However, theophylline is associated with potential adverse effects, and one of the most significant concerns is its potential to cause dysrhythmias (irregular heart rhythms).
Dysrhythmias can include tachycardia (rapid heart rate), atrial fibrillation, or other disturbances in heart rhythm.
Constipation is not a commonly reported adverse effect of theophylline. Oliguria (decreased urine output) is not typically associated with theophylline use. Drowsiness can occur with theophylline, but dysrhythmias are considered a more significant and potentially serious adverse effect. It is crucial for the nurse to educate the client about the potential for dysrhythmias and advise them to report any irregular heartbeat or other cardiac symptoms promptly.
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