A nurse is reinforcing discharge teaching to a client who has bronchitis, about a prescription for albuterol. Which of the following statements should the nurse make?

The client has a confirmed ectopic pregnancy in the right fallopian tube and is scheduled for laparoscopic salpingostomy, which is a surgical emergency to prevent rupture and hemorrhage. Preoperative nursing care focuses on ensuring hemodynamic stability, preparing for potential blood loss, and verifying legal and safety requirements before surgery. Because ectopic pregnancy can rapidly lead to internal bleeding, preparation for IV access, laboratory evaluation, and surgical readiness is essential. The nurse must also ensure adherence to preoperative protocols such as NPO status and informed consent.

Rationale:
A. Preparing an 18-gauge peripheral IV is appropriate because it allows rapid administration of fluids or blood products if hemorrhage occurs during ectopic pregnancy surgery. Larger-bore IV access is essential in surgical patients at risk for significant blood loss. This ensures immediate vascular access for resuscitation if needed.

B. Verifying that the consent form is signed is a legal and safety requirement before surgery. The nurse ensures that informed consent has been obtained after the provider explains the procedure, risks, and benefits. Surgery cannot proceed without valid consent unless it is a life-threatening emergency.

C. Administering AB positive blood products if needed is incorrect because blood type compatibility must be strictly followed. The client’s blood type is B negative, and Rh compatibility is critical to prevent transfusion reactions. Blood products must be matched appropriately, not assumed as AB positive.

D. Reminding the client to remain NPO prior to surgery is essential to reduce the risk of aspiration during anesthesia. Preoperative fasting helps ensure an empty stomach, minimizing complications such as vomiting and aspiration pneumonitis. This is a standard safety measure before all surgical procedures.

E. Administering Rh immune globulin prior to surgery is not appropriate at this time without provider order and timing consideration. Rh immune globulin is typically given after delivery or significant fetal-maternal hemorrhage, not preoperatively in this context. The priority is surgical stabilization rather than prophylactic administration at this stage.

F. Obtaining a complete blood count is important to assess baseline hemoglobin, hematocrit, and platelet levels before surgery. The client already shows mild anemia, which may worsen with surgical blood loss. This information helps guide intraoperative and postoperative management.

G. Explaining the surgical procedure to the client is not the nurse’s role because informed consent and procedural explanation are the responsibility of the provider. The nurse may reinforce understanding but should not introduce or explain the procedure in detail. This could interfere with the legal consent process.

Bronchitis involves inflammation of the bronchial tubes, often leading to airway narrowing, mucus production, and breathing difficulty. Medications such as bronchodilators are commonly prescribed to relieve bronchospasm and improve airflow. Albuterol is a short-acting beta2 agonist used to rapidly relax airway smooth muscles. Patient education focuses on its mechanism of action, proper use, and expected effects.

Rationale:
A. “You can expect to be drowsy after taking this medication.” Albuterol typically causes stimulation of the sympathetic nervous system rather than sedation. Common effects include nervousness, tremors, and tachycardia. Drowsiness is not an expected or therapeutic effect of this medication.

B. “The medication will help open up your airways so you can breathe easier.” This correctly describes the action of albuterol. It stimulates beta2-adrenergic receptors in bronchial smooth muscle, leading to bronchodilation. This reduces airway resistance and improves airflow, making breathing easier for clients with bronchitis or other obstructive airway conditions.

C. “The medication will help thin the mucus your airways produce.” Albuterol does not act as a mucolytic. It does not change the consistency of secretions but instead relaxes bronchial smooth muscle. Medications like expectorants or hydration are used to assist mucus clearance.

D. “You must wait 10 seconds between each inhalation.” Proper inhaler technique generally requires waiting about 1 minute between puffs to allow adequate drug deposition and absorption. The statement does not reflect correct inhalation spacing guidelines and may indicate misunderstanding of proper inhaler use.