A male client with a newly diagnosed seizure disorder starts a prescription for clonazepam. One week later, the nurse observes that his speech is slurred and he has an ataxic gait. Which action should the nurse implement?

A. Sodium: Monitoring sodium is important in many conditions, but diclofenac, a nonsteroidal anti-inflammatory drug (NSAID), is more commonly associated with gastrointestinal bleeding rather than causing significant electrolyte imbalances like hyponatremia. Sodium levels are not the primary concern in this scenario.

B. Glucose: Blood glucose monitoring is critical for clients with diabetes or corticosteroid use, but diclofenac is not known to directly impact glucose metabolism. Reviewing glucose levels would not immediately address the symptoms of pallor and fatigue.

C. Total protein: Total protein levels reflect nutritional and liver status but are not the best marker for acute blood loss or anemia. Changes in total protein would not directly explain symptoms like pallor and fatigue related to NSAID complications.

D. Hemoglobin: Diclofenac can cause gastrointestinal irritation and occult bleeding, leading to anemia. Pallor and fatigue are classic symptoms of low hemoglobin levels, making it the most important laboratory value to review to evaluate for possible GI bleeding and anemia.

• 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.