While a patient is receiving a statin, the nurse knows to monitor the patient closely for the development of which problem?

Choice A reason: Increased appetite is not a common side effect of inhaled corticosteroids due to their minimal systemic absorption. Systemic corticosteroids, like prednisone, stimulate appetite by altering metabolism and increasing hunger signals, but inhaled forms like fluticasone primarily act locally in the lungs, limiting such systemic effects.

Choice B reason: Oral thrush (candidiasis) is a frequent side effect of inhaled corticosteroids. Residual drug in the oral cavity disrupts local microbial flora, promoting Candida albicans overgrowth. Rinsing the mouth after use reduces this risk by removing excess corticosteroid, preventing fungal infections while maintaining anti-inflammatory effects in the airways.

Choice C reason: Hypertension is not typically caused by inhaled corticosteroids, as their systemic absorption is low. Systemic corticosteroids can cause fluid retention and increased blood pressure via mineralocorticoid effects, but inhaled forms like budesonide have minimal impact on cardiovascular parameters, making this an unlikely side effect.

Choice D reason: Constipation is not associated with inhaled corticosteroids. Their action is localized to the respiratory tract, with negligible gastrointestinal effects due to low systemic bioavailability. Systemic corticosteroids may cause metabolic changes, but constipation is not a reported side effect, and inhaled forms do not affect bowel motility.

Choice A reason: Holding albuterol treatment for 24 hours is inappropriate, as jitteriness is a common side effect of beta-2 agonists due to sympathetic stimulation. Albuterol’s benefits in relieving bronchospasm outweigh transient side effects. Discontinuing therapy could worsen asthma symptoms, and monitoring is preferred over stopping treatment.

Choice B reason: Jitteriness is an expected side effect of albuterol, a beta-2 agonist, due to its stimulation of beta-adrenergic receptors, increasing cyclic AMP and causing mild tremors or nervousness. Checking the pulse ensures no serious tachycardia, allowing the nurse to monitor and reassure the patient while continuing necessary therapy.

Choice C reason: Notifying the physician is unnecessary for jitteriness, a common and expected side effect of albuterol. It results from beta-2 receptor stimulation, not a severe adverse reaction. Monitoring vital signs, like pulse, is sufficient to assess the patient’s response without escalating to physician notification immediately.

Choice D reason: Skipping the next albuterol treatment is not warranted, as jitteriness is a transient, expected side effect due to sympathetic stimulation. Albuterol is critical for asthma management, and discontinuation could exacerbate symptoms. Monitoring and patient education about expected effects are more appropriate than altering the treatment schedule.