In a client with a severe asthma attack, which medication should the nurse anticipate administering?

In a client experiencing a severe asthma attack, the primary goal is to provide rapid relief of bronchospasm and improve airflow. Inhaled albuterol, a short-acting beta-2 adrenergic agonist, is the first-line agent for immediate treatment during an acute asthma exacerbation. It acts quickly to relax bronchial smooth muscles, leading to dilation of the airways and alleviation of symptoms such as wheezing and shortness of breath. Administering an inhaled albuterol nebulizer every 20 minutes effectively addresses the urgent need to relieve acute bronchospasm.

Oral montelukast is a leukotriene receptor antagonist that is more suitable as a long-term controller medication for asthma rather than for immediate relief, making it inappropriate for a severe attack. Long-acting salmeterol requires a longer time to take effect and is also meant for daily maintenance therapy rather than immediate rescue, therefore it is unsuitable in acute situations. Oral prednisone is a systemic corticosteroid that may be used later in the course of treatment to reduce inflammation and prevent further exacerbations but is not appropriate for immediate relief during an acute asthma attack.