A client with RSV is experiencing thick mucus and signs of airway obstruction. What medication class should the nurse anticipate administering?

A. 2 capsules:Administering 2 capsules would only provide 1000 mg of the medication, which is 500 mg short of the prescribed dose. This sub-therapeutic dosing would fail to achieve the required plasma concentration for efficacy. It represents an incorrect application of dimensional analysis.

B. 4 capsules:Delivering 4 capsules would result in a total dose of 2000 mg, which is a significant overdose. Excessive dosing increases the risk of pharmacological toxicity and adverse drug reactions. This calculation error violates the fundamental "five rights" of medication administration.

C. 3 capsules:Using dimensional analysis, 1.5 g is converted to 1500 mg; dividing 1500 mg by the 500 mg strength per capsule equals exactly 3. This ensures the patient receives the precise dosage ordered by the provider. It is the correct mathematical result for this conversion.

D. 5 capsules:A dose of 5 capsules would provide 2500 mg, which is nearly double the required 1.5 g amount. Such a large discrepancy in dosing could lead to severe patient harm or legal ramifications for the nurse. It indicates a failure to properly convert grams to milligrams.

A. Increase the dose of the decongestant: Escalating the dosage of a topical sympathomimetic would exacerbate the physiological dependence of the nasal mucosa on the drug. This would worsen rhinitis medicamentosa, a condition where the vasculature remains chronically dilated without the stimulant. Increasing the dose leads to a cycle of progressively severe mucosal edema.

B. Add mucolytics to the treatment regimen: Mucolytics function by breaking disulfide bonds in mucus to decrease its viscosity and facilitate clearance from the respiratory tract. While helpful for clearing secretions, they do not address the underlying localized vasodilation and tissue swelling characteristic of rebound congestion. They provide no mechanism for restoring normal nasal vascular tone.

C. Stop using decongestants and consult the provider: The primary treatment for rhinitis medicamentosa is the immediate cessation of the causative intranasal vasoconstrictor to allow the nasal mucosa to recover. A healthcare provider can then prescribe intranasal corticosteroids to manage the resulting inflammation and transition the patient to a safer therapy. This approach addresses the root cause of the congestion.

D. Switch to antihistamines: Antihistamines are primarily indicated for allergic rhinitis by blocking the H1 receptor-mediated response to allergens. They do not possess the vasoconstrictive properties needed to counteract the profound mucosal engorgement seen in rebound congestion from decongestant overuse. They are ineffective for treating drug-induced nasal vascular dysfunction.