The nurse is admitting a client with an exacerbation of asthma. The medication list includes albuterol, salmeterol, budesonide, cromolyn, and zafirlukast

Question

The client takes these medicines every day, except for the albuterol. When planning the client's care, the nurse recognizes that:
1. The client is taking too many medications, and several should be discontinued.
2. The therapy is adequate, except that the client should be using the albuterol daily.
3. The client needs several additional preparations if the asthma control standards of the Agency for Healthcare Research and Quality are to be met.
4. The client's combination of medications is appropriate according to current practice guidelines.

Answer 1

Correct Answer: 4
Rationale 1: None of these medications should be stopped.
Rationale 2: Albuterol is appropriate as an as-needed short-acting inhaler. It should not be used unless needed.
Rationale 3: These guidelines were established by the National Institutes of Health and are endorsed by the AHRQ.
Rationale 4: Current practice guidelines recommend a long-acting bronchodilator and a steroid for long-term management. Mast cell stabilizer and leukotriene modifiers are also appropriate. Albuterol is appropriate as an as-needed short-acting inhaler.
Global Rationale: In the United States, the National Asthma Education and Prevention Program (NAEPP) issued guidelines for asthma treatment in 1991, which were updated in 1997, 2002, and 2007. The NAEPP guidelines (2007) recommend a stepwise approach to asthma control based on the frequency and severity of symptoms. These medications are part of that approach and no changes are indicated.