A29-year-old female client has sinusitis, so the health care provider orders a topical nasal decongestant. what instructions should be given?

Should be advised that these substances may cause dependence, lead to cardiac side effects, and the importance of avoid exposure to air-conditioning, which dries out the air, and drinking plenty of fluids.

Explanation:

   When an agent gets into the nose and acts as an irritant, the blood vessels, which supply the nose, dilate, the blood volume increases and the turbinates (spongy tissue located on the side walls of the nasal cavity) swell, obstructing the airway, a sign that the Immune system is trying to get rid of the agent. Common colds, flu, rhinitis, sinusitis, allergic attacks, prolonged exposure to air conditioning, are some type of conditions that can make harder the passage of air through the nasal cavity.

The topical nasal decongestants are substances tha provide almost immediate relief because they contain vasoconstricting substances (naphazoline, phenoxazoline, oxymetatazoline, phenylephrine, pseudoephredine) in their formula, resulting in the vessels contract, blood flow slows, mucosal edema subsides, mucus production is low, and people breathe normally again.

  Although the action of the drug is rapid, the sensation of relief is transient. After a while, the nose becomes clogged again, which forces the person to progressively shorten the interval between applications to the point that you always need to have a bottle of medicine to breathe better. This degree of dependence results in a disorder called drug or vasomotor rhinitis, the main symptom of which is a stuffy nose caused by changes in the nasal mucosa that leads to the loss of the ability to contract and dilate vessels without the drug.

  Another problem is that the action of nasal decongestants is not restricted to relieving a stuffy nose. Its continued use causes some of the vasoconstrictor substance that enters the drug's composition to be absorbed into the mucosa, fall into the bloodstream and reach the cardiovascular system, which can be an overload on the heart. Cardiac arrhythmia, tachycardia, high blood pressure, thrombosis, dizziness and headache are some of the signs of the side effect of these drugs in distant organs.

  Avoiding exposure to air-conditioning, which dries out the air, and drinking plenty of fluids to help thin the mucus are other precautions that should be maintained with the treatment.

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