A nurse is caring for a client with asthma who is prescribed metoprolol. The nurse should monitor the client for which of the following?

Increased respiratory rate

Bronchodilation

Decreased sputum production

Wheezing

Answer and Explanation

The Correct Answer is D

Choice A reason: Increased respiratory rate is not a sign of adverse reaction to metoprolol, but rather a normal response to hypoxia or distress. Metoprolol is a betablocker that can lower the heart rate and blood pressure, but it does not affect the respiratory rate directly.

Choice B reason: Bronchodilation is not a sign of adverse reaction to metoprolol, but rather a desired effect of asthma medications such as betaagonists or anticholinergics. Metoprolol is a betablocker that can block the beta receptors in the lungs, which can cause bronchoconstriction or narrowing of the airways. This is why metoprolol is contraindicated or used with caution in clients with asthma.

Choice C reason: Decreased sputum production is not a sign of adverse reaction to metoprolol, but rather a result of effective asthma management. Metoprolol is a betablocker that does not have any direct effect on the mucus secretion or inflammation in the lungs.

Choice D reason: Wheezing is a sign of adverse reaction to metoprolol, as it indicates bronchoconstriction or narrowing of the airways. Metoprolol is a betablocker that can block the beta receptors in the lungs, which can reduce the bronchodilation effect of beta agonists or other asthma medications. This can worsen the asthma symptoms and cause wheezing, coughing, dyspnea, or chest tightness. The nurse should monitor the client for these signs and report them to the prescriber immediately.

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Correct Answer is B

Explanation

Choice A reason: "I am not ready to eat lunch yet." is not a concerning statement for the patient who has completed their Albuterol nebulizer treatment. Albuterol is a medication that relaxes the muscles in the airways and increases the airflow to the lungs, which can improve the breathing and reduce the wheezing in patients with asthma¹. Albuterol does not affect the appetite or the digestion directly, but it may cause some side effects such as nausea, vomiting, or dry mouth, which may reduce the desire to eat. The nurse should respect the patient's preference and offer them food later when they are ready.

Choice B reason: "It feels like my heart is racing." is a concerning statement for the patient who has completed their Albuterol nebulizer treatment. Albuterol is a medication that relaxes the muscles in the airways and increases the airflow to the lungs, but it also stimulates the beta receptors in the heart, which can increase the heart rate and the blood pressure¹. This can cause side effects such as palpitations, chest pain, or arrhythmias, especially in patients with underlying heart conditions or those who take other medications that affect the heart. The nurse should monitor the patient's vital signs, report the finding to the prescriber, and prepare to administer interventions such as betablockers or calcium channel blockers to lower the heart rate and prevent complications.

Choice C reason: "It is easier to breathe now." is not a concerning statement for the patient who has completed their Albuterol nebulizer treatment. Albuterol is a medication that relaxes the muscles in the airways and increases the airflow to the lungs, which can improve the breathing and reduce the wheezing in patients with asthma¹. This is the expected and desired outcome of the Albuterol nebulizer treatment, which indicates that the medication is effective and the patient is responding well. The nurse should document the patient's response and continue to assess the patient's respiratory status and oxygen saturation.

Choice D reason: "I can breathe better now." is not a concerning statement for the patient who has completed their Albuterol nebulizer treatment. Albuterol is a medication that relaxes the muscles in the airways and increases the airflow to the lungs, which can improve the breathing and reduce the wheezing in patients with asthma¹. This is the expected and desired outcome of the Albuterol nebulizer treatment, which indicates that the medication is effective and the patient is responding well. The nurse should document the patient's response and continue to assess the patient's respiratory status and oxygen saturation.

A. I will take this medication with an antacid. B. I will take this medication as needed to reduce pain. C. I will take this medication after I take my proton pump inhibitor (Protonix). D. I will reduce my fluid intake with this medication.

Correct Answer is C

Explanation

Choice A reason: This is incorrect. Taking an antacid with another antacid is redundant and unnecessary. Antacids are medicines that neutralize the acid in the stomach and relieve symptoms of heartburn, indigestion, and gastric ulcers. Taking too much antacid can cause side effects such as diarrhea, constipation, or electrolyte imbalance¹.

Choice B reason: This is incorrect. Taking an antacid as needed to reduce pain is not a good practice. Antacids are not painkillers and do not address the underlying cause of gastric ulcers. Gastric ulcers are sores in the lining of the stomach that can be caused by infection, inflammation, or erosion. Taking an antacid may temporarily relieve the pain, but it does not heal the ulcer or prevent complications. Antacids should be taken regularly as prescribed by the doctor, along with other medicines that treat the cause of the ulcer.

Choice C reason: This is correct. Taking an antacid after taking a proton pump inhibitor (PPI) is a good practice. PPIs are medicines that reduce the production of acid in the stomach and help heal gastric ulcers. However, PPIs may take several hours to work and may not provide immediate relief of symptoms. Taking an antacid after a PPI can help neutralize any remaining acid in the stomach and provide faster symptom relief. However, the antacid should be taken at least 2 hours after the PPI, as the antacid can interfere with the absorption of the PPI.

Choice D reason: This is incorrect. Reducing fluid intake with an antacid is not a good practice. Fluid intake is important for hydration, digestion, and elimination. Reducing fluid intake can cause dehydration, constipation, or kidney problems. Fluid intake does not affect the effectiveness of antacids, as long as the antacid is taken with a glass of water to help dissolve and flush it down the esophagus and into the stomach.

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A nurse is caring for a client with asthma who is prescribed metoprolol. The nurse should monitor the client for which of the following?

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