A patient newly diagnosed with left-sided heart failure is admitted to the hospital. The nurse will observe this patient closely for:

Choice A reason: Decrease in wheezing present on auscultation indicates that albuterol was effective. Albuterol is a bronchodilator that relaxes the smooth muscles of the airways and reduces the airway resistance. This improves the airflow and reduces the wheezing sound that is caused by the turbulent flow of air through the narrowed airways.

Choice B reason: Respiratory rate increased to 38 breaths/min does not indicate that albuterol was effective. It indicates that the patient is still experiencing respiratory distress and hypoxia. The normal respiratory rate for adults is 12 to 20 breaths/min. A high respiratory rate can also be a side effect of albuterol, as it can stimulate the sympathetic nervous system and increase the heart rate and blood pressure.

Choice C reason: Sputum production is clear and watery does not indicate that albuterol was effective. It indicates that the patient has a productive cough and is expelling mucus from the lungs. Sputum production is not directly affected by albuterol, as it does not have anti-inflammatory or mucolytic properties.

Choice D reason: Use of neck muscles does not indicate that albuterol was effective. It indicates that the patient is using accessory muscles to breathe and is exerting more effort to inhale. This is a sign of severe respiratory distress and airway obstruction. Albuterol should relieve the bronchospasm and reduce the need for accessory muscle use.

Choice A reason: Montelukast does not increase vessel permeability. It blocks the effects of leukotrienes, which are inflammatory mediators that cause vessel permeability, bronchoconstriction, and mucus secretion. By blocking leukotrienes, montelukast reduces vessel permeability and inflammation.

Choice B reason: Montelukast reduces bronchoconstriction and mucus secretion. It blocks the effects of leukotrienes, which are inflammatory mediators that cause bronchoconstriction and mucus secretion. By blocking leukotrienes, montelukast improves airflow and reduces asthma symptoms.

Choice C reason: Montelukast does not increase inflammation. It blocks the effects of leukotrienes, which are inflammatory mediators that cause inflammation, bronchoconstriction, and mucus secretion. By blocking leukotrienes, montelukast reduces inflammation and prevents asthma exacerbations.

Choice D reason: Montelukast does not increase bronchoconstriction. It blocks the effects of leukotrienes, which are inflammatory mediators that cause bronchoconstriction, mucus secretion, and inflammation. By blocking leukotrienes, montelukast reduces bronchoconstriction and improves airflow.