A client with a severe cough has a new order for a hydrocodone-based antitussive. Which history assessment would result in changing the prescription?
1. The client has been unable to sleep for 4 nights due to coughing.
2. The client has a history of lung cancer.
3. Hydrocodone makes the client drowsy.
4. The client has a history of persistent intermittent asthma.
Correct Answer: 4
Rationale 1: Lack of sleep due to coughing is a frequently cited reason for ordering narcotic cough medication.
Rationale 2: Hydrocodone is often ordered for clients with bronchial cancers, because the tumor triggers the cough.
Rationale 3: Hydrocodone is a narcotic, so it may cause drowsiness.
Rationale 4: A history of asthma is a concern, because hydrocodone can trigger bronchospasm.
Global Rationale: Care must be taken when using these medications in patients with asthma because bronchoconstriction may occur. Lack of sleep due to coughing is a frequently cited reason for ordering narcotic cough medication. Hydrocodone is often ordered for clients with bronchial cancers, because the tumor triggers the cough. Hydrocodone is a narcotic, so it may cause drowsiness.
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