Which type of medication is the first-line treatment for nasal congestion?

During an acute asthma attack, the airways become narrowed and inflamed, leading to symptoms such as wheezing, shortness of breath, and chest tightness. Short-acting beta2 agonists like Albuterol are the first-line medication for relieving acute asthma symptoms. They work by quickly relaxing the smooth muscles in the airways, resulting in bronchodilation and improved airflow. Albuterol provides rapid relief of symptoms and is often administered via inhalation.
A. Long-acting beta2 agonists (e.g., salmeterol) are typically used as maintenance therapy for long-term control of asthma symptoms, rather than for immediate relief during an acute attack.
C. Corticosteroids (e.g., fluticasone) are anti-inflammatory medications that are often prescribed for asthma, but they are more commonly used as part of a long-term management plan and may not provide immediate relief during an acute attack.
D. Anticholinergics (e.g., ipratropium) are sometimes used in combination with short-acting beta2 agonists for acute asthma exacerbations, but they are not typically the initial treatment choice for an acute asthma attack.

Rebound congestion, also known as rhinitis medicamentosa, is a common adverse effect associated with the prolonged use of nasal decongestants. It occurs when the blood vessels in the nasal passages become dependent on the medication for constriction and lose their ability to regulate naturally. As a result, when the medication wears off, the nasal congestion worsens, leading to a cycle of continued use and worsening symptoms.

In this scenario, the patient's complaint of worsening nasal congestion despite using oxymetazoline every 2 to 4 hours for the past 5 days suggests the possibility of rebound congestion. The nurse should explain to the patient that prolonged or frequent use of nasal decongestants can lead to this effect and recommend gradually tapering off the medication use or discontinuing it altogether. The nurse may also suggest alternative non-medication strategies for managing nasal congestion, such as saline nasal sprays or steam inhalation.