A client receives a prescribed nebulized albuterol treatment for bronchospasm. Which post-treatment finding is an expected beta-adrenergic effect that the nurse should monitor?
1Increased wheezing and bronchospasm within the first 5 minutes
2A heart-rate increase of 20/min with a mild fine hand tremor✓ Correct answer
3Oropharyngeal edema and stridor within the first 15 minutes
4Bilateral pupillary constriction with a heart rate of 50/min
Explanation
Tremor, nervousness, palpitations, and tachycardia are recognized beta-adrenergic effects of albuterol, so a modest pulse increase with fine tremor should be monitored and correlated with symptom relief. Increased bronchospasm may represent paradoxical bronchospasm, and edema with stridor suggests hypersensitivity; both require urgent response. Miosis with bradycardia is not the expected albuterol response.
Clinical reasoning Albuterol relaxes bronchial smooth muscle through beta-2 stimulation, but systemic beta-adrenergic effects can produce tremor, nervousness, palpitations, and an increased pulse.
Decision rule Monitor the pulse and clinical response. Treat new paradoxical bronchospasm or signs of hypersensitivity as urgent rather than expected effects.
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.
Beta-2 agonist — A bronchodilator class that relaxes airway smooth muscle; albuterol is a short-acting example used for bronchospasm.
Beta-adrenergic adverse effects — Tremor, nervousness, palpitations, and tachycardia can occur, especially with greater systemic exposure.
Albuterol-induced hypokalemia — K+ shift into cells with beta-2 stimulation; monitor with frequent dosing or diuretic co-use.