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. At high doses, to treat anaphylaxis: Dopamine is not used to treat anaphylaxis. Anaphylaxis is typically managed with medications such as epinephrine, antihistamines, and corticosteroids.

B. At high doses, to increase cardiac output: Dopamine is a medication commonly used in the treatment of shock, particularly in cases of hypotension. At higher doses, dopamine acts as a positive inotrope and increases cardiac contractility, thereby improving cardiac output and increasing blood pressure.

C. At low doses, to cause increased blood flow to the kidneys: At lower doses, dopamine primarily acts on dopaminergic receptors in the renal vasculature, leading to vasodilation of the renal blood vessels and increased renal perfusion. This can help improve renal blood flow and urine output, making it beneficial in cases of renal hypoperfusion or acute kidney injury.

D. At low doses, to treat anaphylaxis: Dopamine is not used to treat anaphylaxis at any dose. Anaphylaxis is managed with medications such as epinephrine, which acts on multiple receptors to reverse the systemic effects of the allergic reaction.

E. To cause vasoconstriction and increase blood pressure: Dopamine can also cause vasoconstriction, particularly at higher doses. This effect is mediated through its action on alpha-adrenergic receptors, leading to peripheral vasoconstriction and an increase in systemic vascular resistance, which in turn helps increase blood pressure.