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) Treatment with PPIs to decrease stomach acid:
Pancreatic insufficiency is not primarily related to excess stomach acid production, so treatment with proton pump inhibitors (PPIs) to decrease stomach acid would not address the underlying cause of the condition.

B) Treatment with stimulant laxatives:
Pancreatic insufficiency is not typically associated with constipation or the need for stimulant laxatives. While malabsorption of fats due to pancreatic insufficiency can lead to loose stools or diarrhea, treatment with laxatives is not indicated for this condition.

C) Replacement therapy with pancreatic enzymes.
Pancreatic insufficiency is a condition where the pancreas does not produce enough digestive enzymes to properly digest food. Replacement therapy with pancreatic enzymes is the mainstay of treatment for pancreatic insufficiency. These pancreatic enzyme supplements help in the digestion and absorption of nutrients from food by compensating for the deficient enzymes produced by the pancreas. By taking pancreatic enzyme supplements with meals, the client can improve digestion and prevent malnutrition associated with pancreatic insufficiency.

D) Decrease food intake:
Decreasing food intake would not address the underlying cause of pancreatic insufficiency, which is the deficiency of pancreatic enzymes needed for proper digestion. In fact, decreasing food intake could exacerbate malnutrition and nutrient deficiencies in individuals with pancreatic insufficiency. The primary goal of treatment is to improve digestion and nutrient absorption by providing supplemental pancreatic enzymes with meals.

A. Diabetes: Diabetes is not typically a contraindication for decongestant use. However, patients with diabetes should be cautious with decongestants that contain sugar or other ingredients that may affect blood glucose levels.

B. Hypertension: Decongestants can cause vasoconstriction and increase blood pressure, which may exacerbate hypertension. Patients with hypertension should use decongestants cautiously and under the guidance of a healthcare provider.

C. Hyperthyroidism: While decongestants can stimulate the sympathetic nervous system and may exacerbate symptoms of hyperthyroidism such as tachycardia and palpitations, hyperthyroidism is not typically considered a contraindication for decongestant use. However, patients with hyperthyroidism should use decongestants cautiously and consult with their healthcare provider.

D. Heart disease: Decongestants can increase heart rate and blood pressure, potentially worsening symptoms in patients with heart disease such as coronary artery disease, heart failure, or arrhythmias. Patients with heart disease should use decongestants cautiously and consult with their healthcare provider before use.

E. Allergic rhinitis: Decongestants are often used to relieve nasal congestion associated with allergic rhinitis. While patients with allergic rhinitis may use decongestants, they should still use them cautiously and follow the recommended dosage instructions.