RN Nursing · Bronchodilator and Anti-Inflammatory Respiratory Medications · Practice question
A client is prescribed albuterol for asthma exacerbation. Which of the following assessments should the nurse prioritize to monitor for potential side effects of albuterol? Select all that apply.
Elderly client with hypocalcemia
Scenario
A nurse is evaluating an elderly client admitted to the Medical Surgical Unit.Vital Signs
| Vital Sign | 0800 | 1200 |
|---|---|---|
| Temperature | 36.3°C (97.4°F) | 36.3°C (97.4°F) |
| Heart Rate | 75/min | 77/min |
| Respiratory Rate | 18/min | 20/min |
| Blood Pressure | 120/85 mmHg | 115/80 mmHg |
| Oxygen Saturation | 98% on room air | 98% on room air |
Laboratory Results
| Test | 0800 | 1200 | Reference Range |
|---|---|---|---|
| Serum Calcium | 7.9 mg/dL | 7.8 mg/dL | 8.5–10.5 mg/dL |
| Serum Magnesium | 2.1 mg/dL | 2.0 mg/dL | 1.7–2.2 mg/dL |
| Albumin | 4.1 g/dL | 4.0 g/dL | 3.5–5.0 g/dL |
| Serum PTH | 20 pg/mL | 21 pg/mL | 10–65 pg/mL |
Provider Orders
A. Administer IV calcium gluconate 10 mL of 10% solution over 30 minutes. B. Monitor serum calcium every 6 hours. C. Encourage oral hydration of at least 2.5 liters daily.-
Instructing the client to use albuterol with grapefruit juice to enhance bronchodilation.
-
✓
Assessing the client for tremors or hand shakiness.
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✓
Checking the client's heart rate and rhythm for tachycardia or irregularities.
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✓
Observing the client for signs of hypokalemia such as muscle weakness or irregular heartbeat.
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✓
Monitoring the client's blood pressure for hypertension.
Answer & explanation
Correct: Assessing the client for tremors or hand shakiness. · Checking the client's heart rate and rhythm for tachycardia or irregularities. · Observing the client for signs of hypokalemia such as muscle weakness or irregular heartbeat. · Monitoring the client's blood pressure for hypertension.
Albuterol is a beta-2 adrenergic agonist that, at higher doses, can stimulate beta-1 receptors and produce systemic effects. Common side effects include tremors/shakiness (skeletal muscle beta-2 stimulation), tachycardia and dysrhythmias (beta-1 cross-stimulation), hypokalemia (intracellular potassium shift), and hypertension. Grapefruit juice is not used to enhance bronchodilation and is not a safe nursing instruction. Monitoring vital signs, ECG (if indicated), serum potassium, and observing for tremors are essential nursing assessments to ensure safe albuterol therapy. Reference: Lehne's Pharmacology for Nursing Care.
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