The nurse is preparing to administer albuterol to a client experiencing an acute asthma attack. Which medication on the client's medical record is a direct contraindication to albuterol administration?
Beta-Blockers
Anticholinergics
Antihistamines
Glucocorticoids
The Correct Answer is A
A) Beta-Blockers: The use of beta-blockers is a direct contraindication to albuterol administration. Albuterol is a beta-agonist that works by stimulating beta-2 adrenergic receptors to cause bronchodilation. Beta-blockers can antagonize this effect, potentially leading to increased bronchospasm and worsening asthma symptoms. Therefore, if a client is on beta-blockers, caution must be exercised when administering albuterol.
B) Anticholinergics: Anticholinergics, such as ipratropium, are often used in conjunction with beta-agonists like albuterol to provide synergistic effects in managing asthma. There are no direct contraindications between anticholinergics and albuterol, and they can be used together safely to improve bronchial dilation and mucus clearance.
C) Antihistamines: Antihistamines are not contraindicated with albuterol. While they may be used for managing allergic reactions and symptoms, they do not interfere with the action of beta-agonists. Therefore, a client taking antihistamines can still safely receive albuterol for acute asthma attacks.
D) Glucocorticoids: Glucocorticoids, such as prednisone, are often used in asthma management for their anti-inflammatory properties. They are not contraindicated with albuterol; in fact, they are commonly used together in asthma treatment plans. Glucocorticoids help to reduce airway inflammation, while albuterol provides quick relief from bronchospasm.
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Correct Answer is ["A","C","D"]
Explanation
A) Alternative usage includes being the reversal agent for acetaminophen overdoses: Acetylcysteine is indeed used as an antidote for acetaminophen toxicity. It helps replenish glutathione levels in the liver, thus protecting it from damage caused by the overdose. This is a well-established use of the medication.
B) This medication should not be used for clients with productive coughs: This statement is not correct. Acetylcysteine is used to help thin and loosen mucus, making it easier to expel from the lungs. It can be beneficial for clients with productive coughs, as it aids in reducing excessive respiratory secretions.
C) This medication has a foul smell resembling "rotten eggs": Acetylcysteine has a characteristic odor that is often described as similar to rotten eggs due to the presence of sulfur in its chemical structure. This can be an important consideration for patients when administering the medication.
D) This medication can be utilized in clients with cystic fibrosis. This medication falls under the classification of "mucolytic": Acetylcysteine is classified as a mucolytic agent, making it useful for patients with conditions like cystic fibrosis, where thick mucus production is a significant issue. It helps to decrease the viscosity of secretions, facilitating easier clearance.
E) This medication has anticholinergic properties and side effects: This statement is incorrect. Acetylcysteine does not possess anticholinergic properties. Anticholinergic medications typically reduce secretions and are used for different indications, whereas acetylcysteine serves to increase mucus clearance, not decrease it.
Correct Answer is ["C","E"]
Explanation
A. This medication (Benadryl) targets H2 receptors to alleviate symptoms: This statement is incorrect. Diphenhydramine is an H1 receptor antagonist, not an H2 antagonist. H1 receptors are primarily involved in allergic reactions, whereas H2 receptors are related to gastric acid secretion.
B. Take this medication on an empty stomach before breakfast. Drowsiness is a common side effect of diphenhydramine (Benadryl): While drowsiness is indeed a common side effect, taking diphenhydramine on an empty stomach is not necessarily required and may lead to gastrointestinal discomfort. It can be taken with food if preferred.
C. Avoid CNS depressants while taking diphenhydramine (Benadryl): This is an important teaching point. Diphenhydramine can cause sedation, and the use of other CNS depressants (like alcohol or sedatives) can enhance this effect, increasing the risk of excessive drowsiness or other complications.
D. This medication is a 2nd generation antihistamine: This statement is incorrect. Diphenhydramine is actually a first-generation antihistamine. First-generation antihistamines tend to cause more sedation and other side effects compared to second-generation antihistamines, which are less sedating.
E. Paradoxical reactions can be seen with this medication: This is true. In some individuals, particularly children, diphenhydramine can cause paradoxical reactions, such as increased excitability or hyperactivity, rather than the expected sedation. This is an important consideration to discuss with clients.