Patient Data. Exhibits Review history, nurses' notes, and prescriptions. Click to specify which aspects of the 0930 focused assessment indicate adverse reactions to albuterol. 0930 Albuterol given as prescribed via nebulizer. Following the treatment, decreased wheezes noted. The client's hands are trembling and is reporting a headache. Heart rate 129 beats/minute, respirations 20 breaths/minute, blood pressure 125/72 mm Hg, oxygen saturation 99% on room air.

Rationale for correct choices: Tremors: Albuterol stimulates beta-2 adrenergic receptors in skeletal muscle, which can cause fine tremors. This is a well-documented adverse effect and often appears after nebulizer or inhaler treatments. Headache: Increased beta-adrenergic activity and vasodilation in cerebral vessels can lead to headaches. This is another recognized side effect that commonly follows albuterol administration. Tachycardia (heart rate 129): Stimulation of beta-2 receptors can inadvertently activate beta-1 receptors in the heart, leading to an increased heart rate. This cardiovascular effect is considered an adverse reaction that requires monitoring. Rationale for incorrect choices: Decreased wheezes: This is a desired therapeutic effect showing that the drug effectively relieved bronchospasm and improved airway airflow. It does not indicate an adverse reaction. Respiratory rate 20: A decreased respiratory rate from 36 to 20 indicates improved breathing efficiency. This is a positive response to albuterol, not an adverse effect. Blood pressure 125/72: The blood pressure remains within normal limits and does not reflect hypertension or hypotension. Albuterol can sometimes cause minor changes, but this value is stable and not adverse. Oxygen saturation 99%: The improved oxygenation reflects effective bronchodilation and enhanced gas exchange. This is the intended therapeutic outcome, not a negative effect.