A pediatric patient presents to the emergency department with complaints of shortness of breath, increased work of breathing, and a cough. The patient is alert and oriented at times 3, skin is pink, warm and dry. BP 112/68, T99, P106, RR 32. pulse oximetry 90% on room air. Assessment of the lung sounds reveals diminished lung sounds throughout all lung fields. The patient has a past medical history of peanut allergy. The mother tells you that they were at a birthday party and after consumption of a cupcake, the symptoms started. The nurse anticipates that which of the following medications will likely be ordered for this patient?

A. Respiratory rate and pulse: Albuterol is a bronchodilator that works by relaxing the muscles in the airways, improving airflow and reducing wheezing and shortness of breath. After administration, it is important to monitor the respiratory rate to assess the patient’s breathing status and any changes in work of breathing. The pulse should also be monitored because albuterol can cause tachycardia as a side effect. An increase in heart rate is a common reaction to this medication and needs to be assessed to ensure it remains within safe limits.
B. Glucose: Monitoring glucose levels is not typically necessary after administering albuterol unless the patient has diabetes or there is a specific concern for hyperglycemia. Albuterol can cause an increase in blood glucose levels, but this is usually not a primary concern for an acute respiratory distress assessment unless the patient has an underlying condition that warrants it.
C. Pulse oximetry: Pulse oximetry measures the oxygen saturation in the blood, which is crucial for evaluating the effectiveness of albuterol in improving oxygenation. An increase in oxygen saturation levels after administration would indicate improved ventilation and gas exchange. Given that the patient initially has a pulse oximetry reading of 91%, it is important to reassess this to ensure that oxygen levels are improving with treatment.
D. Capillary refill: While capillary refill is an important general assessment for perfusion and circulatory status, it is not specifically required to evaluate the effectiveness of albuterol. It is more relevant in assessing overall circulation rather than the respiratory status directly impacted by albuterol.
E. Lung sounds: Reassessing lung sounds is critical after administering albuterol. The goal is to observe for changes such as reduced wheezing or improved airflow, which would indicate that the bronchodilator is effectively opening the airways. Listening for any changes in breath sounds helps to evaluate the patient’s response to the medication and detect any potential complications like paradoxical bronchospasm.

A. Proton-pump inhibitors: While proton-pump inhibitors (PPIs) help reduce stomach acid and promote ulcer healing, they do not eradicate H. pylori on their own. They are used in combination with antibiotics to treat H. pylori infection.
B. Antibiotics: This is the correct answer. H. pylori is a bacterial infection, and antibiotics are required to eradicate the bacteria. Common regimens include combinations of two or more antibiotics to prevent resistance.
C. H2-receptor blockers: H2-receptor blockers reduce stomach acid but do not eradicate H. pylori. They are supportive treatments to reduce symptoms and promote healing alongside antibiotic therapy.
D. Antacids: Antacids provide symptomatic relief by neutralizing stomach acid but do not treat the underlying H. pylori infection or promote long-term healing of ulcers.