A nurse in a provider’s office is assessing a client. The nurse should identify that which of the following findings are manifestations of pulmonary tuberculosis? (Select all that apply)

Choice A reason: Taking this medication when getting an asthma attack is not a correct way to use montelukast. Montelukast is a leukotriene modifier that helps to reduce inflammation and prevent asthma attacks and exercise induced bronchoconstriction. It is taken once a day in oral form and may cause side effects such as stomach pain, diarrhea, or mood changes. It is not a fast acting rescue medicine for asthma attacks and needs to be taken daily.

Choice B reason: Rinsing the mouth after taking this medication is not necessary or helpful for montelukast. Rinsing the mouth is usually recommended for inhaled corticosteroids, which can cause oral thrush, a fungal infection in the mouth. Montelukast is not an inhaled corticosteroid and does not cause oral thrush.

Choice C reason: Taking this medication once a day in the evening is the correct way to use montelukast. Montelukast works best when taken in the evening, as it can improve the symptoms of asthma and allergic rhinitis that occur at night or early in the morning. Taking it at the same time every day can also help to maintain a steady level of the drug in the body and prevent missed doses.

Choice D reason: Using a spacer device when inhaling this medication is not applicable or useful for montelukast. A spacer device is a tube that attaches to an inhaler and helps to deliver the medication more effectively to the lungs. Montelukast is not an inhaler, but a tablet or a granule that is swallowed.

Choice A reason: The client exhales as the medication is released from the inhaler. This action is incorrect because it wastes the medication and reduces its effectiveness. The client should exhale before using the inhaler, not during.

Choice B reason: The client waits 10 minutes between inhalations. This action is incorrect because it delays the relief of the asthma symptoms. The client should wait only one minute between inhalations, unless instructed otherwise by the doctor.

Choice C reason: The client holds his breath for 10 seconds after inhaling the medication. This action is correct because it allows the medication to reach the lungs and bronchial tubes more effectively and reduce the inflammation and constriction of the airways.

Choice D reason: The client takes a quick inhalation while releasing the medication from the inhaler. This action is incorrect because it can cause the medication to hit the back of the throat and not reach the lungs. The client should take a slow and deep inhalation while using the inhaler.