A nurse is caring for a client who is taking fluticasone due to chronic allergies. The nurse should monitor the client for which of the following adverse effects?

A) Beta-Blockers: The use of beta-blockers is a direct contraindication to albuterol administration. Albuterol is a beta-agonist that works by stimulating beta-2 adrenergic receptors to cause bronchodilation. Beta-blockers can antagonize this effect, potentially leading to increased bronchospasm and worsening asthma symptoms. Therefore, if a client is on beta-blockers, caution must be exercised when administering albuterol.

B) Anticholinergics: Anticholinergics, such as ipratropium, are often used in conjunction with beta-agonists like albuterol to provide synergistic effects in managing asthma. There are no direct contraindications between anticholinergics and albuterol, and they can be used together safely to improve bronchial dilation and mucus clearance.

C) Antihistamines: Antihistamines are not contraindicated with albuterol. While they may be used for managing allergic reactions and symptoms, they do not interfere with the action of beta-agonists. Therefore, a client taking antihistamines can still safely receive albuterol for acute asthma attacks.

D) Glucocorticoids: Glucocorticoids, such as prednisone, are often used in asthma management for their anti-inflammatory properties. They are not contraindicated with albuterol; in fact, they are commonly used together in asthma treatment plans. Glucocorticoids help to reduce airway inflammation, while albuterol provides quick relief from bronchospasm.

A. Use this inhaler 15 minutes prior to physical activity: This is the correct recommendation for cromolyn. It is a mast cell stabilizer that helps prevent asthma symptoms by inhibiting the release of inflammatory mediators. Using it before physical activity can help minimize exercise-induced bronchospasm.

B. Tachycardia is an adverse effect associated with this medication: This statement is misleading. Cromolyn is not typically associated with tachycardia as an adverse effect. Unlike bronchodilators, which can cause increased heart rate, cromolyn primarily works to stabilize mast cells and has a different side effect profile.

C. This medication should not be discontinued abruptly: While it is generally good practice to consult a healthcare provider before stopping any asthma medication, cromolyn does not have a significant risk of withdrawal symptoms like corticosteroids might. It is more important to maintain regular use for effectiveness rather than fear abrupt discontinuation.

D. Injections are required weekly to properly prevent asthma attacks: This statement is incorrect. Cromolyn is administered via inhalation, not by injection, and does not require weekly injections. Patients should use the inhaler as prescribed, typically several times a day, depending on their individual treatment plan.