When teaching a patient who will be receiving antihistamines, the nurse will include which instructions? (Select all that apply)

Drink extra fluids if possible.

Antihistamines may cause restlessness and disturbed sleep.

Avoid activities that require alertness until you know how this medication affects you.

Take the medication on an empty stomach to maximize absorption of the drug.

The medication will begin to work within 30 minutes.

Antihistamines are generally safe to take with other over-the-counter medications.

Answer and Explanation

Correct Answer : A,C

Choice A reason: Drinking extra fluids is advisable with antihistamines, as they can cause dry mouth and mucous membrane dryness due to anticholinergic effects. Increased fluid intake helps alleviate these symptoms, maintains hydration, and supports mucosal function, reducing discomfort while the drug blocks histamine receptors to relieve allergic symptoms.

Choice B reason: Antihistamines, especially first-generation ones like diphenhydramine, typically cause sedation rather than restlessness or disturbed sleep. They block histamine H1 receptors in the central nervous system, leading to drowsiness. Restlessness is more associated with paradoxical reactions in some patients, but sedation is the predominant effect, making this statement incorrect.

Choice C reason: Avoiding activities requiring alertness is critical with first-generation antihistamines, which cross the blood-brain barrier and cause sedation by blocking central histamine receptors. This impairs cognitive and motor functions, increasing the risk of accidents. Patients must assess their response to the drug before engaging in tasks like driving or operating machinery.

Choice D reason: Taking antihistamines on an empty stomach is not necessary, as their absorption is not significantly affected by food. Most antihistamines, like loratadine or diphenhydramine, are well-absorbed regardless of meal timing. This instruction is irrelevant, as the drug’s efficacy depends on receptor binding, not gastrointestinal conditions.

Choice E reason: The onset of action for most antihistamines varies. First-generation antihistamines like diphenhydramine may act within 30 minutes, but second-generation ones like loratadine may take longer (1-3 hours). This statement is not universally accurate, as onset depends on the specific drug, making it unreliable for patient education.

Choice F reason: Antihistamines are not always safe with other over-the-counter medications. They can interact with sedatives, alcohol, or drugs with anticholinergic effects, increasing sedation or toxicity. For example, combining diphenhydramine with other CNS depressants can exacerbate drowsiness, making this statement misleading and potentially dangerous for patients.

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Correct Answer is A

Explanation

Choice A reason: Theophylline, a methylxanthine, causes palpitations by increasing cyclic AMP through phosphodiesterase inhibition, stimulating cardiac beta-1 receptors. This can lead to tachycardia or arrhythmias, especially at high levels. Monitoring heart rate is critical due to theophylline’s narrow therapeutic index and potential for cardiovascular toxicity.

Choice B reason: Diarrhea is not a primary adverse effect of theophylline. Gastrointestinal upset, like nausea or vomiting, may occur due to gastric irritation, but diarrhea is less common. Theophylline’s main toxicities involve the cardiovascular and nervous systems, making palpitations a more significant concern.

Choice C reason: Drowsiness is not associated with theophylline, which acts as a CNS stimulant, potentially causing nervousness or insomnia. Its phosphodiesterase inhibition increases cyclic AMP, enhancing alertness, not sedation. Drowsiness is more linked to antihistamines, making this incorrect for theophylline monitoring.

Choice D reason: Bradycardia is not a typical theophylline effect. Theophylline stimulates the heart via beta-1 receptor activation, causing tachycardia or palpitations. Bradycardia may occur with other drugs, like beta-blockers, but theophylline’s sympathomimetic effects make palpitations a more relevant adverse effect to monitor.

A. Grapefruit juice B. Bran muffins C. Licorice D. Dairy products

Correct Answer is A

Explanation

Choice A reason: Grapefruit juice inhibits hepatic CYP3A4, increasing plasma levels of statins like simvastatin, which are metabolized by this enzyme. This can lead to toxicity, including myopathy or rhabdomyolysis. Patients on antilipemic therapy must avoid grapefruit juice to prevent excessive drug accumulation and adverse effects.

Choice B reason: Bran muffins, high in fiber, do not significantly interact with antilipemic drugs like statins. Fiber may reduce cholesterol absorption, complementing therapy, but it does not affect drug metabolism or efficacy, making it an irrelevant food interaction to discuss for antilipemic therapy.

Choice C reason: Licorice may cause hypokalemia or hypertension, affecting drugs like diuretics, but it has no major interaction with antilipemics like statins. Its effects on mineralocorticoid activity are unrelated to cholesterol-lowering drug metabolism, making it less relevant for antilipemic therapy education.

Choice D reason: Dairy products do not significantly interact with antilipemic drugs. They may affect absorption of bile acid sequestrants, but statins, the most common antilipemics, are unaffected. Grapefruit juice’s impact on statin metabolism is a more critical drug-food interaction to address with patients.

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When teaching a patient who will be receiving antihistamines, the nurse will include which instructions? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

A patient is taking theophylline. The nurse will monitor for which adverse effects associated with the use of this medication?

Correct Answer is A

Explanation

When teaching a patient who is beginning antilipemic therapy about possible drug-food interactions, the nurse will discuss which food?

Correct Answer is A

Explanation

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A patient is receiving hydroxychloroquine therapy but tells the nurse that she has never traveled out of her city. The nurse knows that a possible reason for this drug therapy is which of these conditions?

Which range is the targeted therapeutic adult dosage range of theophylline?

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The nurse is reviewing chloroquine with a patient and instructs the patient to watch for and report which potential adverse reactions?

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