The telephone triage nurse receives a call from a patient asking for a prescription for a narcotic to manage his surgical pain.
The nurse explains that narcotic prescriptions must be written and cannot be called in to the pharmacy.
The patient says, “Why are narcotics so difficult to get a prescription for?” What is the nurse’s best response?

Choice A rationale

Guaifenesin is an expectorant that increases the output of respiratory tract fluid by reducing the adhesiveness and surface tension of the mucus, facilitating the removal of viscous mucus.

Choice B rationale

Dextromethorphan is a cough suppressant that works on the cough center in the brain to reduce the urge to cough. It does not enhance the output of respiratory tract fluid.

Choice C rationale

Acetylcysteine is a mucolytic that breaks down the chemical structure of mucus molecules, making the mucus less viscous, but it does not enhance the output of respiratory tract fluid by reducing adhesiveness.

Choice D rationale

Flunisolide is an inhaled corticosteroid used to reduce inflammation in the airways. It does not enhance the output of respiratory tract fluid.

Choice A rationale

Peripheral edema is more commonly associated with right-sided heart failure rather than left-sided. This is because right-sided heart failure leads to systemic venous congestion, causing fluid to accumulate in the peripheral tissues, particularly in the legs and ankles.

Choice B rationale

Pulmonary edema is a major concern in left-sided heart failure due to the inability of the left ventricle to effectively pump blood out to the systemic circulation. This results in blood backing up into the pulmonary veins, leading to fluid accumulation in the lungs.

Choice C rationale

Liver edema, or hepatomegaly, is more typically seen in right-sided heart failure, where the failure of the right ventricle causes blood to back up into the systemic circulation, affecting the liver and other organs.

Choice D rationale

Abdominal edema, or ascites, is also more associated with right-sided heart failure. This condition occurs due to increased pressure in the veins and capillaries, leading to fluid leakage into the abdominal cavity.