A patient is to receive a beta agonist. Before administration of this medication, which assessment finding would most concern the nurse?

Choice A reason: Benzonatate suppresses cough by anesthetizing stretch receptors in the respiratory tract, reducing the cough reflex. It acts locally on nerve endings in the lungs and pleura, effectively decreasing cough frequency without systemic opioid effects, making it an appropriate choice for cough suppression.

Choice B reason: Guaifenesin is an expectorant, promoting mucus clearance by thinning secretions, not suppressing the cough reflex. It facilitates productive coughing rather than inhibiting it, making it ineffective for cough suppression and an incorrect choice for this indication in managing cough symptoms.

Choice C reason: Dextromethorphan suppresses cough by acting on the medulla’s cough center, reducing the urge to cough. As a non-opioid antitussive, it effectively controls non-productive cough without significant respiratory depression, making it a suitable and correct choice for cough suppression in various conditions.

Choice D reason: Codeine, an opioid, suppresses cough by acting on the central nervous system’s cough center, reducing reflex activity. It’s effective for non-productive cough but carries risks of sedation and dependency, making it a correct but cautiously used choice for cough suppression.

Choice A reason: Renal artery ligation stenosis is affected by beta-blockers’ renin reduction, but asthma’s bronchoconstriction risk is more immediate. Respiratory effects are critical, so this is incorrect.

Choice B reason: Nonselective beta-blockers can cause bronchospasm in asthma by blocking beta-2 receptors. This is a major concern, making it the correct disease to prioritize.

Choice C reason: Diabetes mellitus may mask hypoglycemia with beta-blockers, but asthma’s acute airway risk is more severe. Respiratory issues take precedence, so this is incorrect.

Choice D reason: Coronary artery disease benefits from beta-blockers’ cardiac effects. Asthma’s bronchoconstriction risk is more concerning, so this is incorrect for the primary concern.