A nurse administers a nebulized albuterol treatment to an ad… | MyMerci
Medical EmergenciesPA
Question
A nurse administers a nebulized albuterol treatment to an adult with an acute asthma exacerbation. Which finding should the nurse expect as an EXPECTED short-term effect rather than an adverse reaction?
1Lip swelling and stridor
2Pupillary constriction and bradycardia
3Heart rate increase by 20 and mild fine tremor in the hands✓ Correct answer
4Bronchospasm worsening within 5 minutes
Explanation
Correct (2): Albuterol is a beta-2 selective short-acting agonist, but at clinical doses it has beta-1 spillover causing mild tachycardia and skeletal muscle tremor — both predictable, dose-related, and not signs of toxicity at this level. (1) Paradoxical bronchospasm is rare and concerning. (3) Anaphylaxis. (4) Cholinergic/opioid signs, not beta-agonist effects.
In-depth explanation
Memory Tip Beta-2 agonist side effects = "Tremor, Tachy, Twitchy" — also hypokalemia (K shifts into cells). CPG Check K+ if frequent dosing or with diuretics.
Clinical scenario
Scenario 28-year-old female in acute asthma exacerbation receiving albuterol 2.5 mg nebulizer. Pre-treatment HR 92, post-treatment HR 112 with mild fine tremor.