When teaching a client about nasal decongestant sprays, the nurse should warn that overuse of such medication is most likely to result in which effect?
Ulceration of nasal mucous membranes.
Rebound congestion with nasal stuffiness.
Decreased ability to fight microorganisms.
Nasal irritation and urticaria.
The Correct Answer is B
Choice A rationale
While constant irritation from chemical sprays can potentially damage the delicate tissues, frank ulceration is not the most common or primary clinical concern associated with the short-term overuse of nasal decongestants. The primary mechanism of action for these drugs is vasoconstriction. Chronic use leads to physiological changes in the vascular bed of the nasal mucosa rather than the type of deep tissue destruction that characterizes an ulcer or necrotic lesion in the nose.
Choice B rationale
Nasal decongestants like oxymetazoline work by stimulating alpha-adrenergic receptors, causing vasoconstriction of the nasal blood vessels. However, after prolonged use, the receptors become less responsive, and the vessels dilate excessively as the medication wears off. This is known as rhinitis medicamentosa. It creates a cycle where the patient uses more spray to relieve the worsening congestion, further damaging the nasal vasomotor tone. Normal nasal patency is maintained by a delicate balance of blood flow.
Choice C rationale
Decongestants do not directly suppress the immune system's ability to fight microorganisms. While they may slightly dry out the mucus that traps pathogens, they do not inhibit white blood cell function or antibody production. The primary risk of these medications is localized to the vascular response of the nasal mucosa. Decreased immunity is more commonly associated with systemic corticosteroids or immunosuppressants rather than topical adrenergic agonists used for short periods to treat nasal stuffiness.
Choice D rationale
Although nasal irritation can occur, urticaria is a systemic allergic reaction characterized by hives and is not a typical local effect of nasal spray overuse. Irritation is usually a minor side effect compared to the significant physiological rebound that occurs. Urticaria involves a Type I hypersensitivity reaction with histamine release, whereas the complications of decongestant overuse are related to the downregulation of adrenergic receptors and the resulting loss of vascular control in the nasal passages.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["125"]
Explanation
Step 1 is 1000 mL ÷ 8 hr = 125 mL/hr. Final calculated answer is 125 mL/hr. .
Correct Answer is ["A","B","D"]
Explanation
Choice A rationale
Alcohol is a central nervous system depressant that can significantly potentiate the sedative effects of antihistamines, particularly first-generation ones like diphenhydramine. Combining these substances increases the risk of severe respiratory depression, impaired coordination, and extreme lethargy. For older adults, this combination is particularly dangerous as it markedly increases the risk of falls, confusion, and accidents. Therefore, avoiding alcohol is a critical safety instruction to prevent synergistic CNS depression and ensure the patient's well-being.
Choice B rationale
Antihistamines work by blocking H1 receptors, and many older formulations easily cross the blood-brain barrier, leading to significant drowsiness and sedation. Older adults are more sensitive to these side effects due to age-related changes in metabolism and distribution. Drowsiness can impair the ability to perform daily tasks and increases the risk of injury. Educating the client about this common side effect allows them to plan their activities safely and avoid driving or operating machinery while impaired.
Choice C rationale
Antihistamines should generally not be taken around the clock unless specifically directed for a chronic condition, and even then, they are often taken as needed or at specific intervals like bedtime. For many older adults, taking these medications continuously can lead to an accumulation of anticholinergic side effects, such as urinary retention, constipation, and cognitive impairment. Taking them only when allergy symptoms are present or as a single daily dose helps minimize the total drug burden and potential adverse reactions.
Choice D rationale
Antihistamines often have anticholinergic properties that lead to drying of the mucous membranes, resulting in symptoms like dry mouth, dry eyes, and thickened bronchial secretions. Increasing fluid intake helps to alleviate these drying effects and maintain hydration. For older adults, maintaining adequate hydration is also important for renal clearance of the medication. Encouraging the client to drink more water helps mitigate the uncomfortable "drying out" sensation and supports overall physiological balance during drug therapy. .
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