The nurse cares for a patient with asthma who uses an albuterol (Ventolin) metered dose inhaler. The nurse is most concerned if the patient makes which statement?
A. "The medicine in the inhaler helps me to breathe."
B. "I can use the inhaler as often as needed ."
B. "My hand starts to shake after using the inhaler."
D. "If the inhaler doesn't work, I should dial 911."
Ans: B. "I can use the inhaler as often as needed ."
Rationale: Albuterol can reduce airway resistance in asthma by causing beta2-mediated bronchodilation. If administered in large doses, albuterol will lose selectivity and will activate beta1 receptors, as well as beta2 receptors. Accordingly, patients should be warned not to exceed recommended doses, because doing so may cause tachycardia by activating beta1 receptors in the heart. Tremor is a common adverse effect.
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