A gardener needs a decongestant because of sinus problems and asks the nurse whether he should take an oral form or a nasal spray. Which of these is a benefit of orally administered decongestants?

Choice A reason: Holding albuterol treatment for 24 hours is inappropriate, as jitteriness is a common side effect of beta-2 agonists due to sympathetic stimulation. Albuterol’s benefits in relieving bronchospasm outweigh transient side effects. Discontinuing therapy could worsen asthma symptoms, and monitoring is preferred over stopping treatment.

Choice B reason: Jitteriness is an expected side effect of albuterol, a beta-2 agonist, due to its stimulation of beta-adrenergic receptors, increasing cyclic AMP and causing mild tremors or nervousness. Checking the pulse ensures no serious tachycardia, allowing the nurse to monitor and reassure the patient while continuing necessary therapy.

Choice C reason: Notifying the physician is unnecessary for jitteriness, a common and expected side effect of albuterol. It results from beta-2 receptor stimulation, not a severe adverse reaction. Monitoring vital signs, like pulse, is sufficient to assess the patient’s response without escalating to physician notification immediately.

Choice D reason: Skipping the next albuterol treatment is not warranted, as jitteriness is a transient, expected side effect due to sympathetic stimulation. Albuterol is critical for asthma management, and discontinuation could exacerbate symptoms. Monitoring and patient education about expected effects are more appropriate than altering the treatment schedule.

Choice A reason: Carbapenems, like imipenem, are broad-spectrum antibiotics reserved for severe, multidrug-resistant infections. They are not first-line for uncomplicated urinary tract infections due to their potency and risk of promoting resistance. Sulfonamides are more commonly used for UTIs due to their efficacy and specificity.

Choice B reason: Sulfonamides, like trimethoprim-sulfamethoxazole, are especially useful for urinary tract infections. They inhibit bacterial folate synthesis, targeting pathogens like Escherichia coli, a common UTI cause. Their concentration in urine enhances efficacy, making them a first-line choice for uncomplicated UTIs in susceptible organisms.

Choice C reason: Tetracyclines, like doxycycline, are not typically used for urinary tract infections. They are effective for other infections, like chlamydia, but their spectrum and renal clearance make them less ideal for common UTI pathogens like E. coli compared to sulfonamides or nitrofurantoin.

Choice D reason: Macrolides, like erythromycin, are used for respiratory or soft tissue infections, not primarily for urinary tract infections. They have limited activity against common UTI pathogens like E. coli and do not concentrate effectively in urine, making sulfonamides a more appropriate choice.