Page 1624 - Saunders Comprehensive Review For NCLEX-RN

informed that these medications should not be used for longer than 48 hours.
1. To avoid consuming caffeine in large amounts because
it can increase restlessness and palpitations
2. About the importance of limiting the use of nasal
sprays and drops to prevent rebound nasal
congestion; consider weaning off one nare at a time to
prevent this.
X. Expectorants and Mucolytic Agents (Box 51-4)
A. Description
1. Expectorants loosen bronchial secretions so that they
can be eliminated with coughing; they are used for a
dry unproductive cough and to stimulate bronchial
secretions.
2. Mucolytic agents thin mucous secretions to help make
the cough more productive.
3. Mucolytic agents with dextromethorphan should not
be used by clients with chronic obstructive
pulmonary disease because they suppress the cough.
4. Acetylcysteine can increase airway resistance and
should not be used in clients with asthma. This
medication can also be used to prevent liver damage
in acetaminophen overdose, as well as to protect the
kidneys in the event that diagnostic testing requiring
contrast dye is done.
B. Side and adverse effects
1. Gastrointestinal irritation
2. Rash
3. Oropharyngeal irritation
C. Interventions
1. Acetylcysteine, administered by nebulization, should
not be mixed with another medication.
2. If acetylcysteine is administered with a
bronchodilator, the bronchodilator should be
administered 5 minutes before the acetylcysteine.
3. Monitor for side effects of acetylcysteine such as
nausea and vomiting, stomatitis, and runny nose.

D. Client education

1. To take the medication with a full glass of water to
loosen mucus
2. To maintain adequate fluid intake
3. To cough and deep breathe
XI. Antitussives (Box 51-5)
A. Description: Act on the cough control center in the medulla to
suppress the cough reflex; used for a cough that is nonproductive
and irritating
B. Side and adverse effects
1. Dizziness, drowsiness, sedation

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