A patient with a pulmonary infection is wheezing and has cough. What should be administered?

• A. Mucomyst followed by heated aerosol by mask
• B. Aerosolized Ipratroprium bromide (Atrovent)
• C. IPPB with beta-II agonist
• D. A bronchodilator followed by aerosol via ultrasonic nebulizer

Answer: (D)

Administering a bronchodilator followed by aerosol via ultrasonic nebulizer is correct in this scenario due to the presence of wheezing and cough associated with a pulmonary infection. The wheezing suggests bronchospasm or constriction of the airways, and a bronchodilator helps to relax and open the airways, thereby improving airflow and respiratory function.

Once the airways are dilated, an aerosol treatment can deliver medication effectively to the lungs, helping to alleviate symptoms and address any underlying infection or inflammation. The use of an ultrasonic nebulizer can enhance medication delivery, ensuring that it reaches deeper into the respiratory tract.

The other options may not provide the necessary relief for this patient's immediate symptoms. For example, while aerosolized Ipratropium bromide can help with bronchospasm, it is usually not the first line for acute exacerbations compared to other bronchodilators like beta-agonists. IPPB with a beta-II agonist could be suitable, but it may not be as effective as the combination of a bronchodilator followed by nebulization with an ultrasonic device for this specific situation. Mucomyst, primarily used for cystic fibrosis or acetaminophen overdose, does not directly relieve acute wheezing and coughing related to