Pharmacology Cough & Allergy #4

Question

Which medication order should the nurse question for an asthma patient? Select all that apply.

Answers

  1. Atenolol
    • Rationale:

      This answer is correct because beta blockers, in general, cause bronchoconstriction, which is contraindicated in the already constricted bronchioles of the asthma patient. Therefore, the nurse should question any order for atenolol. If at all possible, these medications should be avoided due to their potential for life-threatening side effects with the asthmatic patient.

  2. Guaifenesin
    • Rationale:

      This answer is not correct because guaifenesin is not prohibited for use in the asthma patient. Acetylcysteine and beta blockers can exacerbate asthma symptoms. These medications should not be used due to their potential for life-threatening side effects with the asthmatic patient.

  3. Montelukast
    • Rationale:

      This answer is not correct because montelukast is used as a maintenance medication for the asthmatic patient. This medication should be taken daily to prevent inflammation and other symptoms associated with asthma. It is not a rescue inhaler, but a daily maintenance medication.

  4. Ipratropium
    • Rationale:

      This answer is not correct because ipratropium is a slow-acting, long-acting bronchodilator used for asthmatic and COPD patients. Ipratropium should never be used as a rescue inhaler, but is administered shortly after albuterol, a medication that is a fast-acting bronchodilator that does not last as long as ipratropium.

  5. Acetylcysteine
    • Rationale:

      This answer is correct because acetylcysteine is contraindicated in asthma patients. Acetulycsteine can exacerbate asthma, therefore any order given for a patient with asthma, the nurse should question. Acetylcysteine should be avoided due to their potential for life-threatening side effects with the asthmatic patient.

Overview

Acetylcysteine and atenolol is contraindicated in asthma patients. Acetylcysteine can worsen bronchospasms and atenolol can illicit bronchoconstriction in asthma patients.

Explanation

Learning Outcomes

Acetylcysteine and most beta blockers, such as atenolol are contraindicated in asthma patients. Acetulycsteine can exacerbate asthma. Beta blockers, in general, cause bronchoconstriction, which is contraindicated in the already constricted bronchioles of the asthma patient. Therefore, the nurse should question any order for atenolol or acetylcysteine. If at all possible, these medications should be avoided due to their potential for life-threatening side effects with the asthmatic patient.

Test Taking Tip

Don’t forget to educate the patient being administered albuterol that they will experience hand tremors, jitteriness, tachycardia, and anxiety as expected side effects. These symptoms will subside within a short time but the effects of opening the airway will be very effective.

Video Rationale