Patient Data

Select from Word Choices to complete the sentence.

The thiazide diuretic works to decrease the client's blood pressure by

______

, and the angiotensin converting enyzme (ACE) inhibitor works to decrease the client's blood pressure by

________

and

_______

A. Calcium 13.0 mg/dL (3.3 mmol/L): Alendronate is used to inhibit bone resorption and is typically prescribed when calcium levels are normal. A high calcium level suggests hypercalcemia, which could worsen if alendronate is given. Therefore, the medication should be withheld, and the healthcare provider must be notified for further evaluation.

B. Magnesium 2.4 mEq/L (2.4 mmol/L): This magnesium level is slightly elevated but is not critically abnormal. Magnesium levels are not a primary consideration when deciding whether to administer alendronate, and this finding alone would not necessitate withholding the medication.

C. Potassium 5.2 mEq/L (5.2 mmol/L): Mild hyperkalemia is noted here, but potassium levels do not directly impact the safety or effectiveness of alendronate. The nurse should monitor it but does not need to withhold alendronate based on this finding.

D. Sodium 132 mEq/L (132 mmol/L): This value indicates mild hyponatremia, but sodium abnormalities are not a direct contraindication to alendronate therapy. The medication could still be administered while addressing the sodium imbalance separately.

• Albuterol is classified as a beta-2 adrenergic agonist that specifically targets bronchial smooth muscle. It causes relaxation and bronchodilation, rapidly relieving bronchospasm in asthma exacerbations. This action improves airway flow and oxygenation almost immediately after administration. It is the primary rescue medication used in acute respiratory distress related to asthma.
• Beta-blockers inhibit beta-adrenergic receptors, leading to decreased heart rate and blood pressure. They can cause bronchoconstriction, especially in patients with reactive airway diseases like asthma. Using beta-blockers would worsen asthma symptoms rather than relieve them during an exacerbation. Therefore, they are contraindicated in many clients with a history of asthma or severe allergies.
• Corticosteroids are anti-inflammatory agents that decrease airway swelling over several hours or days. They do not provide the immediate bronchodilation needed during an acute asthma attack. Fluticasone and prednisone are examples used for long-term asthma control, not acute relief. Thus, corticosteroids differ significantly from bronchodilators like albuterol in onset and purpose.
• Albuterol reduces airway resistance by relaxing constricted bronchial smooth muscles. This effect allows greater airflow into and out of the lungs, improving oxygen exchange. Decreased airway resistance is the primary mechanism by which respiratory symptoms are relieved. Effective bronchodilation is critical to restoring normal breathing during asthma exacerbations.
• Albuterol may increase heart rate slightly due to beta-1 receptor cross-stimulation at high doses. It does not decrease heart rate and tachycardia is considered a known side effect. Heart rate monitoring is important during albuterol administration, especially in cardiac patients. Managing asthma symptoms requires balancing effective bronchodilation with minimal cardiac effects.
• Albuterol does not directly act on inflammation but instead targets smooth muscle relaxation. The inflammatory response in asthma is treated with corticosteroids and leukotriene modifiers. Immediate asthma symptom relief depends on bronchodilation, not anti-inflammatory action. Thus, albuterol is classified solely as a bronchodilator, not an anti-inflammatory medication.