A nurse is assessing a client who has a prescription for oral albuterol for the long-term management of asthma.
For which of the following adverse effects should the nurse monitor?
Nystagmus.
Tachycardia.
Drowsiness.
Oral fungal infections.
The Correct Answer is B
Choice A rationale
Nystagmus, an involuntary rhythmic eye movement, is not a recognized or common adverse effect of oral albuterol. Albuterol is a beta-2 adrenergic agonist primarily acting on bronchial smooth muscle to cause bronchodilation. Its side effects are typically related to sympathetic nervous system stimulation, not oculomotor dysfunction.
Choice B rationale
Tachycardia is a common adverse effect of oral albuterol due to its systemic absorption and stimulation of beta-1 adrenergic receptors in the heart, in addition to its primary beta-2 effects on the lungs. This leads to an increased heart rate (normal range 60-100 bpm) and can cause palpitations, especially in sensitive individuals or with higher doses.
Choice C rationale
Drowsiness is not a typical adverse effect of oral albuterol. In fact, due to its stimulant properties, albuterol is more likely to cause central nervous system excitation, leading to insomnia, nervousness, or tremors rather than sedation. Its action is to activate adrenergic pathways, which generally promote alertness.
Choice D rationale
Oral fungal infections, such as oral candidiasis (thrush), are commonly associated with inhaled corticosteroids, not oral albuterol. Inhaled corticosteroids suppress the local immune response in the oral cavity, allowing opportunistic fungal growth. Oral albuterol does not have immunosuppressive effects on the oral mucosa.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Sodium bicarbonate is used to treat metabolic acidosis or certain drug overdoses, but it does not directly address hypocalcemia, which is the underlying cause of a positive Trousseau's sign. Its primary action is to increase systemic pH, not calcium levels.
Choice B rationale
Magnesium sulfate is administered for magnesium deficiencies, pre-eclampsia, or certain arrhythmias. While magnesium deficiency can sometimes exacerbate hypocalcemia, it is not the primary treatment for Trousseau's sign, which specifically indicates low calcium.
Choice C rationale
Calcium gluconate is the appropriate medication to administer for a positive Trousseau's sign, as this sign indicates hypocalcemia (low serum calcium levels). Calcium gluconate directly replenishes calcium, correcting the neuromuscular excitability caused by insufficient extracellular calcium.
Choice D rationale
Potassium chloride is given to treat hypokalemia (low potassium levels). While electrolyte imbalances can be complex, a positive Trousseau's sign is specifically indicative of hypocalcemia, not hypokalemia, and potassium administration would not resolve the underlying issue.
Correct Answer is C
Explanation
Choice A rationale
Urinary retention is a potential adverse effect of opioid analgesics like meperidine due to their anticholinergic effects, which can relax the detrusor muscle and increase bladder sphincter tone. While important to monitor, it is not the most immediate life-threatening concern compared to respiratory depression.
Choice B rationale
Vomiting is a common gastrointestinal adverse effect of opioid analgesics, often due to stimulation of the chemoreceptor trigger zone in the brainstem. While distressing for the client and requiring intervention, it does not pose the immediate life-threatening risk that respiratory depression does.
Choice C rationale
Meperidine is an opioid agonist that acts on mu-opioid receptors in the central nervous system, including the brainstem respiratory centers. This can lead to dose-dependent respiratory depression by decreasing the sensitivity of these centers to carbon dioxide, making a depressed respiratory rate (normal range 12-20 breaths/min) the priority assessment for client safety.
Choice D rationale
Altered level of consciousness, such as drowsiness or sedation, is a common central nervous system effect of meperidine. While a significant finding indicating opioid effect, it is secondary in priority to respiratory depression, which directly impacts vital gas exchange and can quickly become life-threatening.
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