Because the bronchodilators or antiasthma drugs may be given for asthma, emphysema, or chronic bronchitis, the preadministration assessment of the patient requires careful observation and documentation. The nurse takes the blood pressure, pulse, and respiratory rate before therapy with a bronchodilator or antiasthma drug is initiated. Respiratory rates below 12/min or above 24/min are considered abnormal. It is important to assess the lung fields and carefully document the sounds heard before therapy is begun. The nurse notes any dyspnea, cough, wheezing (a musical sound of the respiratory tract caused by air passing through a narrowed bronchial tube), "noisy" respirations, or use of accessory muscles when breathing. If the patient is raising sputum, the nurse records a description of the sputum. The nurse notes and records the patient's general physical condition. It is important to record any signs of hypoxia (eg, mental confusion, restlessness, anxiety, and cyanosis [bluish discoloration of the skin and mucous membranes]). In some instances the primary heath care provider may order arterial blood gas analysis or pulmonary function tests.
In patients with chronic asthma, question the patient concerning allergies, frequency of attacks, severity of attacks, factors that cause or relieve attacks, and any antiasthma drugs used currently or taken previously.
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