A nurse is caring for a 24-year-old client who has frequent premature atrial contractions seen on the cardiac monitor. The nurse understands that the client requires additional education when the client selects which of the following items for the breakfast tray?

A. Fluticasone is a corticosteroid inhaler used for maintenance therapy to reduce inflammation in the airways over time. It is not a rescue medication for acute symptoms. Clients with COPD should use short-acting bronchodilators (such as albuterol) as their first-line treatment for relieving acute symptoms like shortness of breath or wheezing.
B. This statement is correct. Fluticasone is a corticosteroid medication that, when inhaled, can increase the risk of developing oral candidiasis (thrush). Clients should be instructed to rinse their mouth with water and spit after using the inhaler to minimize this risk. Inspecting the mouth daily for signs of white patches, soreness, or difficulty swallowing is important. If thrush develops, clients may need antifungal treatment.
C. This statement is not necessary for fluticasone inhaler use. Fluticasone is not known to significantly affect heart rate. Monitoring heart rate before each dose is more relevant for medications that can cause changes in heart rate, such as bronchodilators (e.g., beta-agonists). However, clients should monitor for symptoms like palpitations or rapid heart rate and report them to their healthcare provider.
D. Fluticasone is a maintenance medication that should be taken regularly as prescribed, regardless of symptoms. Skipping doses can lead to worsening of COPD symptoms and exacerbations. Clients should adhere to the prescribed dosing schedule to achieve optimal control of their condition.

A. Retropulsion is a classic manifestation of postural instability in Parkinson's disease. It refers to a tendency to lose balance and fall backward, especially when attempting to initiate walking or when challenged with external forces.
B. Impaired handwriting, also known as micrographia, is associated with bradykinesia (slowness of movement) in Parkinson's disease. It manifests as progressively smaller and more cramped handwriting.

C. Muscle soreness and pain can occur in Parkinson's disease, but they are not typically directly associated with postural instability. They may occur due to rigidity (muscle stiffness) or abnormal postures maintained over time.
D. Slow movements, or bradykinesia, are a hallmark feature of Parkinson's disease and are characterized by a gradual reduction in the speed and fluidity of voluntary movements. While related to motor symptoms in Parkinson's disease, slow movements are not specific to postural instability.