The nurse caring for a patient with a productive cough would anticipate an order for the following medication:

Choice A reason: "If my breathing begins to feel tight, I will use the cromolyn immediately." is an incorrect statement for the client who has asthma and new prescriptions for Albuterol and Atrovent, both by nebulizer. Cromolyn is a medication that prevents the release of inflammatory substances from the mast cells in the airways, which can cause bronchospasm and asthma symptoms¹. Cromolyn is not a rescue medication, but a maintenance medication that should be used regularly to prevent asthma attacks. The client should use Albuterol, a short acting beta agonist, to relieve acute bronchospasm and wheezing.

Choice B reason: "I will be sure to take the albuterol before taking the Atrovent." is a correct statement for the client who has asthma and new prescriptions for Albuterol and Atrovent, both by nebulizer. Albuterol is a medication that relaxes the muscles in the airways and increases the airflow to the lungs, which can improve the breathing and reduce the wheezing in patients with asthma. Atrovent is a medication that blocks the action of acetylcholine, a neurotransmitter that causes bronchoconstriction and mucus secretion, which can worsen the asthma symptoms. The client should take the Albuterol before the Atrovent, as this will allow the Albuterol to open the airways and enhance the absorption and effectiveness of the Atrovent.

Choice C reason: "I will administer the medications 10 minutes apart." is an unnecessary statement for the client who has asthma and new prescriptions for Albuterol and Atrovent, both by nebulizer. The client does not need to wait 10 minutes between the administration of the two medications, as they can be given together in the same nebulizer chamber. This will save time and simplify the treatment regimen for the client. The client should follow the instructions on the medication label or the prescriber's order regarding the dosage and frequency of the nebulizer treatments.

Choice D reason: "I will use both medications immediately after exercising." is an inappropriate statement for the client who has asthma and new prescriptions for Albuterol and Atrovent, both by nebulizer. The client should not use both medications immediately after exercising, as this may not prevent or relieve exercise induced bronchospasm, a condition that causes the airways to narrow during or after physical activity. The client should use Albuterol, a short acting beta agonist, before exercising, as this will prevent the bronchospasm and allow the client to exercise safely and comfortably. The client should use Atrovent, an anticholinergic, as prescribed, usually twice a day, to control the chronic symptoms of asthma.

Choice A reason: Dextromethorphan (Robitussin) is not the correct medication for a patient with a productive cough. Dextromethorphan is a cough suppressant that works by acting on the brain to reduce the cough reflex. Dextromethorphan is used for a dry, nonproductive cough that is caused by irritation or inflammation. Dextromethorphan is not effective for a productive cough that produces mucus, and it may even be harmful by preventing the clearance of secretions from the lungs.

Choice B reason: Fluticasone (Flonase) is not the correct medication for a patient with a productive cough. Fluticasone is a corticosteroid that works by reducing inflammation and swelling in the nasal passages. Fluticasone is used for allergic rhinitis, which is a condition that causes sneezing, itching, and runny nose due to an allergic reaction. Fluticasone is not effective for a productive cough that produces mucus, and it may even worsen it by suppressing the immune system and increasing the risk of infection.

Choice C reason: Pseudoephedrine (Sudafed) is not the correct medication for a patient with a productive cough. Pseudoephedrine is a decongestant that works by constricting the blood vessels in the nasal passages and sinuses. Pseudoephedrine is used for nasal congestion, which is a condition that causes stuffy nose and difficulty breathing due to swelling of the mucous membranes. Pseudoephedrine is not effective for a productive cough that produces mucus, and it may even cause side effects such as increased blood pressure, insomnia, and anxiety.

Choice D reason: Guaifenesin (Mucinex) is the correct medication for a patient with a productive cough. Guaifenesin is an expectorant that works by thinning and loosening the mucus in the chest and throat. Guaifenesin is used for a productive cough that produces mucus, as it helps the cough to be more effective and clear the airways. Guaifenesin is generally safe and well tolerated, but it may cause some minor side effects such as nausea, vomiting, and headache.