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) H2-receptor blockers:
H2-receptor blockers, such as ranitidine and famotidine, are commonly used to reduce stomach acid production and treat peptic ulcer disease. They help promote ulcer healing and alleviate symptoms. These medications are generally safe and appropriate for use in clients with peptic ulcer disease.

B) Antacids:
Antacids are medications that neutralize stomach acid and provide symptomatic relief from peptic ulcer disease. While they do not directly treat the underlying cause of the ulcer, they can help alleviate symptoms such as pain and discomfort. Antacids are generally safe for use in clients with peptic ulcer disease.

C) PPIs (Proton Pump Inhibitors):
PPIs, such as omeprazole and pantoprazole, are potent acid-suppressing medications commonly used to treat peptic ulcer disease and gastroesophageal reflux disease (GERD). They are effective at reducing stomach acid production and promoting ulcer healing. PPIs are generally safe and appropriate for use in clients with peptic ulcer disease.

D) NSAIDs (Nonsteroidal Anti-Inflammatory Drugs).
NSAIDs, such as ibuprofen, aspirin, and naproxen, can exacerbate peptic ulcer disease by increasing the risk of gastric irritation, erosion, and ulceration. These medications inhibit the production of prostaglandins, which help protect the stomach lining. Chronic or excessive use of NSAIDs can lead to the development of new ulcers or worsening of existing ulcers. Therefore, clients with peptic ulcer disease are typically advised to avoid NSAIDs or to use them with caution under the guidance of a healthcare provider.

A. At high doses, to treat anaphylaxis: Dopamine is not used to treat anaphylaxis. Anaphylaxis is typically managed with medications such as epinephrine, antihistamines, and corticosteroids.

B. At high doses, to increase cardiac output: Dopamine is a medication commonly used in the treatment of shock, particularly in cases of hypotension. At higher doses, dopamine acts as a positive inotrope and increases cardiac contractility, thereby improving cardiac output and increasing blood pressure.

C. At low doses, to cause increased blood flow to the kidneys: At lower doses, dopamine primarily acts on dopaminergic receptors in the renal vasculature, leading to vasodilation of the renal blood vessels and increased renal perfusion. This can help improve renal blood flow and urine output, making it beneficial in cases of renal hypoperfusion or acute kidney injury.

D. At low doses, to treat anaphylaxis: Dopamine is not used to treat anaphylaxis at any dose. Anaphylaxis is managed with medications such as epinephrine, which acts on multiple receptors to reverse the systemic effects of the allergic reaction.

E. To cause vasoconstriction and increase blood pressure: Dopamine can also cause vasoconstriction, particularly at higher doses. This effect is mediated through its action on alpha-adrenergic receptors, leading to peripheral vasoconstriction and an increase in systemic vascular resistance, which in turn helps increase blood pressure.