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) 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.

A) Theophylline:
Theophylline is a bronchodilator medication that is used for the long-term management of asthma, but it is not typically used as the initial treatment for acute asthma exacerbations. Its onset of action is slower compared to short-acting beta agonists like albuterol.

B) Montelukast:
Montelukast is a leukotriene receptor antagonist that is used for the long-term management of asthma, but it is not typically used as the initial treatment for acute asthma exacerbations. Its onset of action is slower compared to short-acting beta agonists like albuterol.

C) Albuterol.
The patient is presenting with symptoms consistent with an asthma exacerbation, including shortness of breath, increased work of breathing, expiratory wheezing, and a history of asthma. Albuterol is a short-acting beta agonist bronchodilator commonly used as the first-line treatment for acute asthma exacerbations. It acts quickly to relax bronchial smooth muscles, relieve bronchoconstriction, and improve airflow, which can help alleviate the patient's symptoms of shortness of breath and wheezing.

D) Salmeterol:
Salmeterol is a long-acting beta agonist bronchodilator that is used for the maintenance treatment of asthma, but it is not typically used as the initial treatment for acute asthma exacerbations. Its onset of action is slower compared to short-acting beta agonists like albuterol, and it is not recommended for rapid relief of acute symptoms.