In treating a client with acute status asthmaticus, which medication should the nurse administer first?

In the case of acute status asthmaticus, the immediate focus is on relieving airway constriction to improve the client's breathing. Albuterol, a short-acting beta-agonist, acts as a bronchodilator that rapidly relaxes the smooth muscles of the airways, providing quick relief from bronchospasm. Administering albuterol first is crucial in this situation because it allows for rapid improvement in airflow and helps alleviate respiratory distress.

Other medications, such as prednisone, are corticosteroids that help reduce inflammation but take time to exert their effects and are not suitable as a first-line treatment in acute scenarios. Gentamicin, an antibiotic, is not indicated for the acute management of asthma exacerbations unless a bacterial infection is present. Salmeterol is a long-acting beta-agonist and is intended for maintenance therapy rather than immediate relief during an acute asthma attack, which makes it less effective in this urgent context.

Thus, administering albuterol as the first medication in acute status asthmaticus is critical for quickly alleviating symptoms and improving the patient's condition.