A nurse is caring for a client who has received an albuterol nebulization treatment. Which of the following findings should the nurse instruct the client to observe as an adverse effect of this medication?

Albuterol is a short-acting beta-2 agonist (SABA) that induces bronchodilation by relaxing smooth muscle in the airway. While it primarily targets pulmonary receptors, it can also stimulate beta-1 receptors in the heart and beta-2 receptors in skeletal muscle. This systemic stimulation results in cardiovascular and neuromuscular side effects that clients must be able to identify. Rationale: A. Albuterol is more likely to cause an increase in blood pressure and heart rate rather than a decrease, due to its sympathomimetic properties. Stimulation of the adrenergic system increases cardiac output and peripheral resistance. Therefore, instructing the client to watch for hypotension would be clinically inaccurate and could lead to a failure to recognize relevant cardiovascular side effects. B. Increased appetite is not a recognized adverse effect of albuterol nebulization. The medication acts as a stimulant, which typically has a neutral or mildly suppressive effect on appetite rather than an inductive one. The nurse should focus education on cardiovascular and neurological symptoms that are direct consequences of the medication’s action on the sympathetic nervous system. C. Tremors are a classic adverse effect of albuterol because the drug stimulates beta-2 receptors in the skeletal muscles, causing fine muscle contractions. This is particularly common after nebulized treatments where a higher systemic dose may be absorbed. The nurse should reassure the client that this effect is common but should be reported if it becomes severe or interferes with daily activities. D. Muscle weakness is not an expected side effect of albuterol; instead, muscle excitability or cramping is more common. While albuterol can cause a temporary shift of potassium into cells (hypokalemia), which can lead to weakness, it is not the primary side effect clients should observe for. Tremors are a far more frequent and immediate neuromuscular response to beta-agonist therapy.