An adult patient presents to the emergency department with complaints of shortness of breath and increased work of breathing.

Assessment

The patient is alert and oriented times 3, skin is pink, warm and dry. BP 148/88, T98, P92. R 24, pulse oximetry 91% on room air. Assessment of the lung reveals expiratory wheezing throughout the lung fields.

The physician orders an albuterol nebulizer. What assessments should the nurse plan to complete after administering the albuterol?

(Select All that Apply.)

A) Sedation:
Sedation is not an adverse effect commonly associated with oxymetazoline nasal spray. Oxymetazoline works by constricting blood vessels in the nasal passages to relieve congestion and does not typically cause sedation.

B) Constipation:
Constipation is not an adverse effect associated with oxymetazoline nasal spray. Constipation is more commonly associated with medications that affect the gastrointestinal system, such as opioid analgesics or certain anticholinergic medications.

C) Productive cough:
Productive cough is not an adverse effect commonly associated with oxymetazoline nasal spray. Productive cough refers to a cough that produces mucus or phlegm and is more often associated with respiratory infections or chronic respiratory conditions.

D) Nasal congestion.
Oxymetazoline (Afrin) is a nasal decongestant spray commonly used for the temporary relief of nasal congestion associated with allergic rhinitis or the common cold. However, if oxymetazoline nasal spray is used for more than 3 to 5 consecutive days, it can lead to rebound congestion, also known as rhinitis medicamentosa. Rebound congestion occurs when the nasal mucosa becomes dependent on the medication for vasoconstriction, and upon discontinuation, nasal congestion worsens. Therefore, prolonged use of oxymetazoline nasal spray can result in a worsening of nasal congestion as an adverse effect.

A) A client who has a kidney stone:
Misoprostol is not contraindicated in clients who have kidney stones. Kidney stones are not a known contraindication for the use of misoprostol.

B) A client who is pregnant.
Misoprostol is a medication commonly used to prevent gastric ulcers in individuals who are taking nonsteroidal anti-inflammatory drugs (NSAIDs) for conditions such as osteoarthritis. However, it is contraindicated in pregnant women due to its potential to cause uterine contractions, leading to miscarriage or preterm labor. Misoprostol is classified as a pregnancy category X medication, meaning that there is clear evidence of fetal risk based on human or animal studies, and its use is contraindicated during pregnancy.

C) A client who has a urinary tract infection:
Misoprostol is not contraindicated in clients who have urinary tract infections. Urinary tract infections are not a known contraindication for the use of misoprostol.

D) A client who has osteoarthritis:
Misoprostol is commonly used in clients with conditions such as osteoarthritis to prevent NSAID-induced gastric ulcers. Osteoarthritis is not a contraindication for the use of misoprostol when indicated for gastric ulcer prevention in individuals taking NSAIDs.