A nurse is measuring the vital signs of a client he suspects has hypovolemic shock.
Which of the following findings should the nurse expect?

Choice D rationale:

The nurse should seek clarification for the prescribed medication Propranolol when caring for a client with an exacerbation of asthma. Propranolol is a non-selective beta-blocker, and its use can exacerbate bronchoconstriction and potentially worsen asthma symptoms. In patients with asthma, non-selective beta-blockers are generally contraindicated. The nurse should consult with the provider to ensure that Propranolol is the appropriate choice, as there may be safer alternatives to manage the client's condition without worsening their asthma.

Choice A rationale:

Prednisone is a corticosteroid commonly used to reduce inflammation and manage asthma exacerbations. It is an appropriate medication for asthma management and does not require clarification.

Choice B rationale:

Montelukast is a leukotriene receptor antagonist that is also used in the management of asthma. It helps to reduce airway inflammation and bronchoconstriction. Montelukast is an appropriate choice for asthma and does not need further clarification.

Choice C rationale:

Aminophylline is a bronchodilator that can be used in the treatment of asthma. While it may have potential side effects and interactions, it is not the first medication that needs clarification in this scenario. Propranolol, due to its potential to worsen asthma symptoms, takes precedence.

Choice A rationale:

Fine rales Fine rales, also known as crackles, are typically associated with conditions like pulmonary edema, pneumonia, or interstitial lung diseases. These sounds are often described as "crackling" or "popping" and are heard during inspiration. In an acute asthma exacerbation, expiratory wheezing is more characteristic than fine rales.

Choice B rationale:

Rhonchi Rhonchi are continuous, low-pitched sounds that can be heard in conditions like chronic obstructive pulmonary disease (COPD) or bronchitis. They are typically present during both inspiration and expiration. In an acute asthma exacerbation, you would expect to hear wheezing during expiration, which is different from the characteristics of rhonchi.

Choice D rationale:

Pleural friction rub Pleural friction rub is a grating, leathery sound caused by the inflamed pleura rubbing against each other. It is typically heard during both inspiration and expiration and is associated with conditions like pleuritis or pleurisy. It is not commonly associated with acute asthma exacerbation. Now, let's move on to the next question.