A client with open-angle glaucoma is using pilocarpine opthalmic solution, a miotic agent. Which action should the nurse at the eye clinic include in evaluating the effectiveness of the medication?

• 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.

A. Avoid the use of alcohol: Metronidazole can cause a disulfiram-like reaction when combined with alcohol, leading to severe nausea, vomiting, flushing, tachycardia, and hypotension. Clients must be strictly advised to avoid all forms of alcohol, including hidden sources like cough syrups, during treatment and for at least 48 hours after completing therapy.

B. Drink a liter of water daily: While staying hydrated is generally good for overall health, it's not a specific requirement directly related to the action or side effects of metronidazole for C. difficile colitis. Maintaining adequate fluid intake is important for managing diarrhea associated with the infection, but it's not a direct instruction tied to the medication itself.

C. Keep medication refrigerated: Metronidazole tablets or oral suspension do not require refrigeration; they should be stored at room temperature. Refrigeration is not necessary and could even alter the medication’s consistency or effectiveness.

D. Take one hour after eating: Metronidazole is generally better tolerated when taken with food to minimize gastrointestinal upset. Advising clients to take it after eating can help but is not mandatory nor the most crucial teaching point compared to alcohol avoidance.