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) Beta-Blockers: The use of beta-blockers is a direct contraindication to albuterol administration. Albuterol is a beta-agonist that works by stimulating beta-2 adrenergic receptors to cause bronchodilation. Beta-blockers can antagonize this effect, potentially leading to increased bronchospasm and worsening asthma symptoms. Therefore, if a client is on beta-blockers, caution must be exercised when administering albuterol.

B) Anticholinergics: Anticholinergics, such as ipratropium, are often used in conjunction with beta-agonists like albuterol to provide synergistic effects in managing asthma. There are no direct contraindications between anticholinergics and albuterol, and they can be used together safely to improve bronchial dilation and mucus clearance.

C) Antihistamines: Antihistamines are not contraindicated with albuterol. While they may be used for managing allergic reactions and symptoms, they do not interfere with the action of beta-agonists. Therefore, a client taking antihistamines can still safely receive albuterol for acute asthma attacks.

D) Glucocorticoids: Glucocorticoids, such as prednisone, are often used in asthma management for their anti-inflammatory properties. They are not contraindicated with albuterol; in fact, they are commonly used together in asthma treatment plans. Glucocorticoids help to reduce airway inflammation, while albuterol provides quick relief from bronchospasm.

A. Stimulate alpha-adrenergic receptors, thus producing vascular constriction of capillaries in nasal mucosa: This describes the action of decongestants, not guaifenesin. Guaifenesin does not work by constricting blood vessels; rather, its primary function is to help manage mucus production.

B. Compete with histamine for receptor sites, thus preventing a histamine response and overall congestion: This mechanism is associated with antihistamines, which are used to relieve symptoms of allergic reactions, not with guaifenesin. Guaifenesin does not block histamine but focuses on mucus management.

C. Treat allergic rhinitis and prevent motion sickness: While these are common uses for antihistamines, they do not apply to guaifenesin. Guaifenesin is primarily an expectorant and is not indicated for treating allergic rhinitis or motion sickness.

D. Loosen bronchial secretion to assist in elimination: Guaifenesin acts as an expectorant, promoting the clearance of mucus from the airways by loosening bronchial secretions. This facilitates easier expectoration of mucus, helping to relieve chest congestion associated with upper respiratory infections.