The nurse is preparing to administer albuterol to a client experiencing an acute asthma attack. Which medication on the client's medical record is a direct contraindication to albuterol administration?

A. Hypertension: Fluticasone, a corticosteroid, is not typically associated with causing hypertension directly. However, chronic use can lead to fluid retention and hypertension in some individuals, but it is not a primary concern compared to other side effects.

B. Fungal infections: This is a significant adverse effect associated with inhaled corticosteroids like fluticasone. Prolonged use can increase the risk of oral thrush and other fungal infections due to the immunosuppressive effects of corticosteroids. Monitoring for signs of infection is crucial.

C. Decreased immunity: While long-term use of systemic corticosteroids can lead to decreased immune function, inhaled fluticasone is less likely to cause significant immunosuppression. However, it can still impact local immunity in the airways, making monitoring for infections more relevant than generalized immune suppression.

D. Hypoglycemia: Fluticasone is not known to cause hypoglycemia. In fact, corticosteroids typically can lead to increased blood glucose levels rather than lowering them, especially with chronic use, making this option inaccurate in the context of monitoring for adverse effects.

A. Stimulates effects of histamine by occupying all H receptor sites: This statement inaccurately describes the action of diphenhydramine. Instead of stimulating histamine effects, diphenhydramine actually blocks them, particularly at H1 receptors, which are involved in allergic responses.

B. Blocks effects of histamine by competing and occupying H1 receptor sites: This accurately describes the mechanism of action of diphenhydramine. As an antihistamine, it competes with histamine for binding to H1 receptor sites, effectively reducing symptoms of allergies, such as sneezing, itching, and nasal congestion.

C. Blocks effects of histamine by competing and occupying H2 receptor sites: This option is incorrect because H2 receptor antagonists are used primarily to reduce gastric acid secretion, not to treat allergic reactions. Diphenhydramine specifically targets H1 receptors, not H2 receptors.

D. Stimulates effects of histamine by increasing the amount of H2 receptor sites: This statement is also incorrect. Diphenhydramine does not stimulate histamine activity or increase receptor sites. Instead, it functions to inhibit the action of histamine at H1 receptors, which is fundamental in alleviating allergy symptoms.