An adult patient presents to the emergency department with complaints of shortness of breath and increased work of breathing.

Assessment

The patient is alert and oriented times 3, skin is pink, warm and dry. BP 148/88, T98, P92. R 24, pulse oximetry 91% on room air. Assessment of the lung reveals expiratory wheezing throughout the lung fields.

The physician orders an albuterol nebulizer. What assessments should the nurse plan to complete after administering the albuterol?

(Select All that Apply.)

A. Metered-dose inhaler (MDI): MDIs deliver a specific dose of medication in aerosol form. They consist of a pressurized canister containing medication and a mouthpiece or mask for inhalation. Patients must coordinate inhalation with actuation to ensure proper medication delivery to the lungs.

B. Nebulizer: Nebulizers convert liquid medication into a fine mist that can be inhaled directly into the lungs. They are commonly used for patients who have difficulty using MDIs or require higher doses of medication. Nebulizers are often used in acute care settings or at home for patients with chronic respiratory conditions.

C. Hypodermic syringe: Hypodermic syringes are used for administering injections subcutaneously, intramuscularly, or intravenously. They are not used for inhalation medication administration.

D. Feeding tube syringe: Feeding tube syringes are used for administering liquid medications or enteral feeds through feeding tubes directly into the gastrointestinal tract. They are not used for inhalation medication administration.

E. Dry powder inhaler (DPI): DPIs deliver medication in powdered form, which is activated by the patient's inhalation. Unlike MDIs, DPIs do not require coordination between actuation and inhalation. Instead, patients inhale forcefully to disperse the medication into their lungs.

A) Antihistamines:
Antihistamines are commonly used in the treatment of allergic reactions, including anaphylaxis. They work by blocking the effects of histamine, which is released during an allergic reaction, and can help alleviate symptoms such as itching, hives, and nasal congestion. Antihistamines are typically included in the treatment regimen for anaphylaxis but should not be relied upon as the sole treatment.

B) Vasodilators.
Vasodilators are medications that widen blood vessels, leading to a decrease in blood pressure. In the context of anaphylaxis, where blood pressure can drop precipitously due to systemic vasodilation, the use of vasodilators can exacerbate hypotension, potentially worsening the patient's condition. Therefore, vasodilators should be avoided in the management of anaphylaxis.

C) Corticosteroids:
Corticosteroids, such as prednisone or methylprednisolone, are used in the management of anaphylaxis to reduce inflammation and prevent late-phase allergic reactions. They are not typically used as first-line treatment during the acute phase of anaphylaxis but may be administered after initial stabilization to prevent recurrence of symptoms.

D) Bronchodilators:
Bronchodilators, such as albuterol, are used to relieve bronchospasm and improve airflow in conditions such as asthma and chronic obstructive pulmonary disease (COPD). While bronchospasm can occur during anaphylaxis, bronchodilators may still be used to address this symptom. However, they should be used cautiously, and their administration should not delay the administration of epinephrine, which is the primary treatment for anaphylaxis.