The nurse is teaching the patient about the medication albuterol for the treatment of chronic obstructive pulmonary disease (COPD). Which medication adverse effect will the nurse teach the patient to monitor for and report?

Choice A reason: Administering a platelet transfusion immediately is not indicated for a platelet count of 45,000/mm³. While this is below the normal range, it is not critically low. Platelet transfusions are typically reserved for patients with life-threatening bleeding or extremely low platelet counts.

Choice B reason: Monitoring the patient for signs of bleeding and educating about bleeding precautions is the appropriate intervention. Patients with thrombocytopenia are at an increased risk of bleeding, and it is essential to educate them on how to minimize this risk, such as avoiding activities that can cause injury, using a soft toothbrush, and avoiding over-the-counter medications that can affect platelet function.

Choice C reason: Administering aspirin to reduce the risk of clot formation is incorrect. Aspirin is an antiplatelet agent that can increase the risk of bleeding in patients with thrombocytopenia. It should be avoided unless specifically prescribed for another condition with close monitoring.

Choice D reason: Encouraging the patient to engage in regular physical exercise to improve circulation is not appropriate in this context. While physical activity is generally beneficial, it should be done with caution in patients with thrombocytopenia to avoid injury and bleeding. The focus should be on safety and bleeding precautions.

Choice A reason: Hypoventilation is not a cause of respiratory alkalosis. Hypoventilation leads to respiratory acidosis due to the retention of carbon dioxide (CO2). Respiratory alkalosis occurs when there is excessive exhalation of CO2, leading to a higher pH (alkaline).

Choice B reason: Panic attacks can cause respiratory alkalosis due to hyperventilation. During a panic attack, a person may breathe rapidly and deeply, leading to excessive loss of CO2. This reduces the CO2 levels in the blood and increases the pH, resulting in respiratory alkalosis.

Choice C reason: Pneumonia is more likely to cause respiratory acidosis or metabolic acidosis rather than respiratory alkalosis. Pneumonia can impair gas exchange, leading to CO2 retention and decreased oxygen levels, which are not typical triggers for respiratory alkalosis.

Choice D reason: Congestive heart failure can lead to respiratory alkalosis, but it is more commonly associated with metabolic acidosis due to poor perfusion and anaerobic metabolism. Hyperventilation in heart failure patients can lead to respiratory alkalosis, but panic attacks are a more direct and common cause.