A practical nurse is caring for an adult client experiencing an acute asthma exacerbation. The client appears restless, and auscultation of the lungs reveals bilateral expiratory wheezing. The client's current vital signs are blood pressure 134/86 mmHg, heart rate 114 beats per minute, respiratory rate 26 breaths per minute, and oxygen saturation 92% on room air. The healthcare provider has prescribed an immediate albuterol nebulizer treatment and an oral dose of prednisone. Which action should the nurse take first?
- AWithhold the albuterol nebulizer and notify the provider, as the client is already experiencing tachycardia.
- BDelegate the administration of the oral prednisone to an unlicensed assistive personnel (UAP) while preparing the nebulizer.
- Administer the albuterol nebulizer treatment before providing the oral prednisone.Answer
- DAdminister the oral prednisone immediately without checking the client's identification band to save time.
Answer
Administer the albuterol nebulizer treatment before providing the oral prednisone.
The correct action is to administer the albuterol nebulizer treatment first. Albuterol is a short-acting beta-2 agonist (SABA) that causes rapid bronchodilation, addressing the client's immediate airway and breathing needs. Prednisone is a corticosteroid that reduces airway inflammation, but its onset of action takes several hours. In an acute respiratory scenario, the nurse must prioritize the fastest-acting rescue medication to stabilize the client's airway before administering slower-acting oral medications.
Step-by-Step Solution
Key Concept
During an acute respiratory exacerbation, rapid-acting bronchodilators (like albuterol) must be prioritized over slower-acting anti-inflammatory medications (like oral corticosteroids) to immediately secure the airway and improve breathing.