Using a stepwise approach to managing asthma, a nurse teaches a patient who is at step 1 that their albuterol MDI (Proventil) is used:

Choice A reason: Glucuronidation does not primarily involve fecal excretion; it conjugates drugs for urinary excretion. Hydrolysis is unrelated, and fecal routes are secondary, so this is incorrect for glucuronidation’s role.

Choice B reason: Glucuronidation conjugates drugs, making them water-soluble for transport across renal tubules and excretion in urine. This is the primary mechanism, making it the correct choice for drug elimination.

Choice C reason: Enterohepatic recirculation involves some drugs, but glucuronidation aims for excretion, not recycling. Prolonging drug presence is not the goal, so this is incorrect for the process.

Choice D reason: Glucuronidation facilitates excretion, not reabsorption. Reabsorbing drugs would counteract its purpose of eliminating metabolites, making this incorrect compared to urinary excretion.

Choice A reason: Furosemide, a loop diuretic, promotes potassium excretion, risking hypokalemia. The patient’s potassium level (3.1 mEq/L) is below normal (3.5-5.0 mEq/L), indicating hypokalemia, which can cause arrhythmias. Administering Lasix without addressing this could worsen the electrolyte imbalance, making this choice unsafe and incorrect.

Choice B reason: Oxygen administration addresses respiratory issues, not electrolyte imbalances like hypokalemia (3.1 mEq/L) caused by furosemide. There’s no indication of hypoxia in the lab results or scenario. This action doesn’t correct the potassium deficit or prevent further depletion, making it irrelevant and incorrect.

Choice C reason: Furosemide exacerbates hypokalemia (patient’s potassium: 3.1 mEq/L), risking cardiac arrhythmias or muscle weakness. Holding the dose prevents further potassium loss, and notifying the physician allows for correction (e.g., potassium supplements) and reassessment of therapy, making this the safest and most appropriate action.

Choice D reason: A 24-hour urine collection assesses renal function or output but doesn’t address the immediate concern of hypokalemia (3.1 mEq/L) caused by furosemide. This test is irrelevant to correcting the electrolyte imbalance or preventing further depletion, making it an inappropriate action in this scenario.