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) Theophylline:
Theophylline is a bronchodilator medication that is used for the long-term management of asthma, but it is not typically used as the initial treatment for acute asthma exacerbations. Its onset of action is slower compared to short-acting beta agonists like albuterol.

B) Montelukast:
Montelukast is a leukotriene receptor antagonist that is used for the long-term management of asthma, but it is not typically used as the initial treatment for acute asthma exacerbations. Its onset of action is slower compared to short-acting beta agonists like albuterol.

C) Albuterol.
The patient is presenting with symptoms consistent with an asthma exacerbation, including shortness of breath, increased work of breathing, expiratory wheezing, and a history of asthma. Albuterol is a short-acting beta agonist bronchodilator commonly used as the first-line treatment for acute asthma exacerbations. It acts quickly to relax bronchial smooth muscles, relieve bronchoconstriction, and improve airflow, which can help alleviate the patient's symptoms of shortness of breath and wheezing.

D) Salmeterol:
Salmeterol is a long-acting beta agonist bronchodilator that is used for the maintenance treatment of asthma, but it is not typically used as the initial treatment for acute asthma exacerbations. Its onset of action is slower compared to short-acting beta agonists like albuterol, and it is not recommended for rapid relief of acute symptoms.

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.