Topical Nasal Decongestants

Question 1

Topical Nasal Decongestants

Drug Names

Answer 1

“zoline”

Phenylephrine

Question 2

Topical Nasal Decongestants

Actions

Answer 2

Sympathomimetic drugs imitate effects of the SNS to cause vasoconstriction which decreases edema and inflammation of the nasal membrane

Question 3

Topical Nasal Decongestants

Indications

Answer 3

Nasal congestion

Dilation of the nares (opening of the nasal passage) for (1) medical exams and (2) to help middle ear pressure

Question 4

Topical Nasal Decongestants

Contraindications and Cautions

Answer 4

Contraindications:
Lesion or erosion in the mucous membranes

Cautions:
Any condition that might be exacerbated by sympathetic activity because of the adrenergic properties: glaucoma, HTN, prostate issues
Pregnancy and lactation

Question 5

Topical Nasal Decongestants

Adverse Effects

Answer 5

• Local stinging and burning
• Rebound congestion if used longer than 3-5 days
• Sympathomimetic effects like increased HR and BP, urinary retention

Question 6

Topical Nasal Decongestants

Drug-Drug Interactions

Answer 6

• Cyclopropane or halothane
• Other sympathomimetic drugs
• Sympathetic-blocking drugs

Question 7

Topical Nasal Decongestants

Nursing Process: Assessment

Answer 7

History:

• any contraindications or cautions
• Allergy
• Conditions that may be worsened by sympathomimetic drugs: HTN, glaucoma, prostate issues
• Pregnancy and lactation

Physical Exam:

• Baseline
• Skin color and temperature, vital signs, cardiac auscultation
• Lung sounds
• Urinary status for urinary retention
• Nasal mucus membranes/lesions
• Orientation and reflexes (CNS effects)

Question 8

Topical Nasal Decongestants

Nursing Process: Diagnoses

Answer 8

Acute pain r/t local effects of the drug and adverse effects

Deficient knowledge r/t drug regimen

Question 9

Topical Nasal Decongestants

Nursing Process: Implementation

Answer 9

How to administer the drug (Box 54.2)

Non-pharmacologic measures

Do not taken longer than one week

Further medical evaluation for persistent symptoms

Overdose prevention

Safety measures if dizziness or sedation occurs

Question 10

Topical Nasal Decongestants

Nursing Process: Evaluation

Answer 10

• Patient response (symptom relief and adverse effects)
• Effectiveness of teaching plan
• Effectiveness of other measures to relieve symptoms
• Compliance