A nurse is prioritizing clients in an urgent care setting. Which client(s) would benefit most from the use of a small volume nebulizer (SVN)? Select all that apply.

A. A client with an emphysema exacerbation: Clients experiencing an acute exacerbation of emphysema often have increased airway obstruction and difficulty breathing. A small volume nebulizer delivers bronchodilators directly to the lungs, providing rapid relief of bronchospasm and improving oxygenation.

B. A client experiencing an asthma attack: During an asthma attack, airway constriction can be severe. An SVN allows precise delivery of inhaled medications like albuterol, which rapidly dilate the airways and reduce respiratory distress, making it essential for urgent intervention.

C. A client with a common cold and fever: A common cold typically causes mild upper respiratory symptoms such as congestion and runny nose. SVNs are not indicated for routine cold management, as bronchodilator therapy is not necessary in uncomplicated viral infections.

D. A client with significant respiratory symptoms: Clients showing significant respiratory distress, regardless of underlying cause, may benefit from an SVN to administer medications that relieve bronchospasm, decrease airway inflammation, and improve ventilation rapidly.

E. A client with mild seasonal allergies: Mild seasonal allergies usually present with sneezing, watery eyes, and nasal congestion without significant airway obstruction. SVNs are not indicated for mild allergic symptoms, as oral or intranasal antihistamines are sufficient.

A. Loratadine can interfere with the accuracy of the test: Loratadine is a second-generation antihistamine that blocks H1 receptors. Continuing the medication can suppress allergic responses, leading to false-negative results during allergy testing, which is why it must be discontinued several days beforehand.

B. Loratadine can cause increased sensitivity to allergens: Loratadine does not increase sensitivity to allergens. Its mechanism involves reducing the body’s allergic response, not enhancing it, so this is not a reason to stop the medication before testing.

C. Loratadine can cause hypotension during the allergy test: Loratadine does not significantly affect blood pressure. Hypotension is not a known effect of loratadine during allergy testing, so this is not a valid reason for discontinuation.

D. Loratadine can cause an allergic reaction during the test: Loratadine itself is unlikely to trigger an allergic reaction. The purpose of stopping the drug is to prevent interference with test results, not to prevent a reaction caused by the medication.