A client has prescriptions for albuterol (Proventil HFA) and salmeterol (Serevent). Which instruction should the nurse provide for this client?

A) This is normal.
Guaifenesin is an expectorant medication commonly used to help loosen and thin mucus in the airways, making it easier to cough up. Coughing up phlegm after taking guaifenesin is an expected response and indicates that the medication is working as intended. Guaifenesin helps to clear the airways of excess mucus, which can be particularly beneficial for individuals with respiratory conditions such as bronchitis or chest congestion.

B) This requires further investigation.
Coughing up phlegm after taking guaifenesin is a common and expected response and does not typically indicate a need for further investigation unless there are other concerning symptoms present. It is important for the nurse to provide reassurance and education about the expected effects of the medication.

C) This is indicative of an allergic reaction.
Coughing up phlegm after taking guaifenesin is not indicative of an allergic reaction. Allergic reactions to guaifenesin are rare but may include symptoms such as rash, itching, swelling, dizziness, or difficulty breathing. If the client were experiencing these symptoms, it would be important to assess further for a possible allergic reaction and intervene accordingly.

D) This means there is probably more pathology present.
Coughing up phlegm after taking guaifenesin does not necessarily indicate the presence of more pathology. It simply indicates that the medication is helping to loosen and mobilize mucus in the airways, which is a normal response to expectorant therapy. If the client has concerns about their symptoms, further assessment by a healthcare provider may be warranted, but coughing up phlegm alone is not necessarily indicative of worsening pathology.

A. Decreased cardiac output: Inotropic medications are intended to improve cardiac function and increase cardiac output, so monitoring for signs of decreased cardiac output would be contrary to the expected therapeutic effect of these medications.

B. Increased afterload: Inotropic medications primarily affect the contractility of the heart muscle and do not typically have a direct effect on afterload (the force against which the heart must pump blood). While changes in afterload can occur as a secondary consequence of altered cardiac function, monitoring for signs of increased afterload would not be the primary focus after administering an inotropic medication.

C. Increased cardiac output.
Inotropic medications are drugs that affect the contractility of the heart muscle. They are often used in the management of shock to improve cardiac function and increase cardiac output. Therefore, after administering an inotropic medication, the nurse would monitor the patient for signs of increased cardiac output, such as improved peripheral perfusion, increased blood pressure, and resolution of signs and symptoms of shock.

D. Slowing of the heart rate: Inotropic medications can affect heart rate indirectly by altering cardiac output, but their primary effect is on contractility rather than heart rate. Monitoring for signs of bradycardia (slowing of the heart rate) may be appropriate in certain clinical situations, but it is not the primary consideration after administering an inotropic medication for shock.