A client who is obtunded arrives in the emergency department with a suspected drug overdose. The client becomes responsive after the administration of IV naloxone, but within a short period, the client's level of consciousness decreases again and the respiratory rate decreases to 6 breaths/minute. Which action should the nurse take first?

A. Explain the need to refrain from alcohol use while taking the drug: Although avoiding alcohol is very important when taking clonazepam due to increased central nervous system depression, the client’s current symptoms of slurred speech and ataxia are concerning side effects that must be addressed first through immediate clinical intervention rather than just education.

B. Document the client's continued seizure activity: Slurred speech and ataxia are not typical signs of seizure activity; they are more indicative of central nervous system depression or toxicity from clonazepam. Simply documenting the symptoms without further action could delay critical treatment adjustments.

C. Advise the client to discontinue the medication immediately: Abruptly stopping clonazepam can lead to withdrawal seizures and other serious complications. Medication discontinuation should always be managed carefully under the direction of the healthcare provider to prevent additional risks.

D. Report these side effects to the healthcare provider: Slurred speech and an ataxic gait suggest clonazepam toxicity or overdose. Promptly notifying the healthcare provider allows for dosage adjustment or possible medication change, which is essential to prevent worsening central nervous system depression and maintain patient safety.

• Albuterol is classified as a beta-2 adrenergic agonist that specifically targets bronchial smooth muscle. It causes relaxation and bronchodilation, rapidly relieving bronchospasm in asthma exacerbations. This action improves airway flow and oxygenation almost immediately after administration. It is the primary rescue medication used in acute respiratory distress related to asthma.
• Beta-blockers inhibit beta-adrenergic receptors, leading to decreased heart rate and blood pressure. They can cause bronchoconstriction, especially in patients with reactive airway diseases like asthma. Using beta-blockers would worsen asthma symptoms rather than relieve them during an exacerbation. Therefore, they are contraindicated in many clients with a history of asthma or severe allergies.
• Corticosteroids are anti-inflammatory agents that decrease airway swelling over several hours or days. They do not provide the immediate bronchodilation needed during an acute asthma attack. Fluticasone and prednisone are examples used for long-term asthma control, not acute relief. Thus, corticosteroids differ significantly from bronchodilators like albuterol in onset and purpose.
• Albuterol reduces airway resistance by relaxing constricted bronchial smooth muscles. This effect allows greater airflow into and out of the lungs, improving oxygen exchange. Decreased airway resistance is the primary mechanism by which respiratory symptoms are relieved. Effective bronchodilation is critical to restoring normal breathing during asthma exacerbations.
• Albuterol may increase heart rate slightly due to beta-1 receptor cross-stimulation at high doses. It does not decrease heart rate and tachycardia is considered a known side effect. Heart rate monitoring is important during albuterol administration, especially in cardiac patients. Managing asthma symptoms requires balancing effective bronchodilation with minimal cardiac effects.
• Albuterol does not directly act on inflammation but instead targets smooth muscle relaxation. The inflammatory response in asthma is treated with corticosteroids and leukotriene modifiers. Immediate asthma symptom relief depends on bronchodilation, not anti-inflammatory action. Thus, albuterol is classified solely as a bronchodilator, not an anti-inflammatory medication.