Which physiological response will the nurse expect to assess in patients taking hydralazine (Apresoline), which is a vasodilator medication?

Choice A reason: Use of accessory breathing muscles is a sign of respiratory distress and increased work of breathing. Accessory muscles are the muscles of the neck, chest, and abdomen that assist the diaphragm and intercostal muscles in breathing. They are normally not used for breathing, but they are recruited when the airway is obstructed or the lung function is impaired.

Choice B reason: Foul-smelling sputum is not a sign of an acute asthma episode. It is a sign of a bacterial infection or a lung abscess. Sputum is the mucus that is coughed up from the lungs. It can have different colors, textures, and odors depending on the cause and severity of the condition.

Choice C reason: Feeling of chest tightness is a sign of an acute asthma episode. It is caused by the bronchoconstriction, or the narrowing of the airways, that occurs during an asthma attack. It can also be accompanied by pain or pressure in the chest.

Choice D reason: Coughing is a sign of an acute asthma episode. It is a reflex action that tries to clear the airways of mucus, irritants, or foreign particles. It can also be triggered by the inflammation and hypersensitivity of the airways that occur during an asthma attack.

Choice E reason: Expiratory wheezing is a sign of an acute asthma episode. It is a high-pitched whistling sound that is heard when the person exhales. It is caused by the turbulent flow of air through the narrowed airways. It can also be heard on inspiration, but it is more prominent on expiration.

Choice A reason: Glucocorticoids can cause an increase in blood sugar by stimulating gluconeogenesis and inhibiting insulin action. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will not have no change in blood sugar, but rather a rise in blood sugar.

Choice B reason: Glucocorticoids can cause an increase in blood pressure by promoting sodium and water retention and increasing vascular reactivity. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will not have a decrease in the blood pressure, but rather a possible increase in the blood pressure.

Choice C reason: Glucocorticoids can cause an increase in blood sugar by stimulating gluconeogenesis and inhibiting insulin action. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will have an increase in blood sugar. This is the correct statement that describes the expected effect of glucocorticoids in this patient.

Choice D reason: Glucocorticoids can cause an increase in blood sugar by stimulating gluconeogenesis and inhibiting insulin action. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will not have an increase in the need for carbohydrates, but rather a need for more insulin to control the blood sugar.