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 D
Explanation
Choice A rationale
Restlessness, also known as akathisia, is not a typical expected adverse effect of ondansetron. Ondansetron primarily acts as a selective 5-HT3 receptor antagonist, blocking serotonin's emetogenic effects in the chemoreceptor trigger zone and gastrointestinal tract. Common adverse effects are generally mild, including headache, constipation, or diarrhea, with neurological effects like restlessness being rare and atypical for this drug's primary mechanism.
Choice B rationale
Ondansetron should be administered prophylactically, typically 30 minutes *before* chemotherapy, to achieve optimal antiemetic effect. Its mechanism involves blocking serotonin receptors that, when activated by chemotherapy, trigger nausea and vomiting. Pre-emptive administration ensures therapeutic drug levels are present to counteract the emetogenic stimuli effectively before their onset.
Choice C rationale
Acute nausea and vomiting associated with chemotherapy can persist for significantly longer than 12 hours, often lasting for 24 to 48 hours or even longer depending on the specific chemotherapeutic agent and its emetogenic potential. The duration of emesis is highly variable and directly related to the drug's pharmacokinetic profile and the extent of serotonin release.
Choice D rationale
If nausea persists despite ondansetron administration, it indicates an inadequate antiemetic response, likely due to the complex neurochemical pathways involved in chemotherapy-induced nausea and vomiting. This often necessitates a multi-modal approach, involving the addition of other antiemetic agents like corticosteroids (e.g., dexamethasone) or neurokinin-1 receptor antagonists (e.g., aprepitant) to target different emetogenic pathways for more complete symptom control.
Correct Answer is C
Explanation
Choice A rationale
Disulfiram is an aldehyde dehydrogenase inhibitor used in the treatment of chronic alcoholism, causing an unpleasant reaction when alcohol is consumed. It has no pharmacological antagonism to opioids and would not be effective in reversing the effects of hydromorphone toxicity.
Choice B rationale
Epinephrine is a potent vasoconstrictor and bronchodilator, primarily used in anaphylaxis and cardiac arrest. While it stimulates adrenergic receptors, it does not counteract the central nervous system depression caused by opioid toxicity and is not a specific antidote for hydromorphone.
Choice C rationale
Naloxone is an opioid antagonist that competitively binds to opioid receptors, displacing opioid agonists like hydromorphone. This action rapidly reverses the central nervous system and respiratory depression characteristic of opioid toxicity, restoring ventilation and consciousness.
Choice D rationale
Flumazenil is a benzodiazepine receptor antagonist, used to reverse the effects of benzodiazepine overdose. It has no affinity for opioid receptors and therefore would be ineffective in treating hydromorphone toxicity, which is mediated by opioid receptor activation.
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