A client with type 2 diabetes mellitus is managed with glimepiride. The primary healthcare provider (HCP) adds a new prescription for injectable exenatide. Which information is most important for the nurse to teach this client?

• 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. Nausea: Morphine commonly causes nausea, which can lead to dizziness and unsteadiness when standing or moving. This increases the client’s risk of falls, especially when transitioning from bed to chair or ambulating postoperatively.

B. Euphoria: While morphine may cause a sensation of euphoria, this emotional effect alone does not directly contribute to physical instability or fall risk in the immediate postoperative period.

C. Itching: Itching is a common side effect of opioids but does not impair balance or mobility directly, so it is not a significant contributor to fall risk.

D. Orthostatic hypotension: Morphine can cause vasodilation, leading to drops in blood pressure when moving from lying to sitting or standing. Orthostatic hypotension can result in lightheadedness or fainting, sharply increasing the risk of falls.

E. Seizures: Seizures are rare side effects of morphine, typically associated with very high doses or toxicity. They are not in standard therapeutic use to be considered a primary fall risk factor.

F. Urinary retention: Urinary retention is a side effect of morphine but does not directly cause instability or contribute to falls unless it leads to urgency and hurried movement, which is less typical.

G. Sedation: Sedation is one of the most significant opioid side effects contributing to falls. Reduced alertness and slower reflexes make it much harder for clients to safely ambulate or protect themselves from falls.