Pharmacology Cough & Allergy #4

Question

Which medication order should the nurse question for an asthma client? 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 client. 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 client.

  2. Guaifenesin
    • Rationale:

      This answer is not correct because guaifenesin is not prohibited for use in the asthma client. 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 client.

  3. Montelukast
    • Rationale:

      This answer is not correct because montelukast is used as a maintenance medication for the asthmatic client. 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 clients. 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 clients. Acetulycsteine can exacerbate asthma, therefore any order given for a client with asthma, the nurse should question. Acetylcysteine should be avoided due to their potential for life-threatening side effects with the asthmatic client.

Overview

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

Explanation

Learning Outcomes

Acetylcysteine and most beta blockers, such as atenolol are contraindicated in asthma clients. Acetulycsteine can exacerbate asthma. Beta blockers, in general, cause bronchoconstriction, which is contraindicated in the already constricted bronchioles of the asthma client. 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 client.

Test Taking Tip

Don’t forget to educate the client 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