A nurse is caring for a child who has asthma and a prescription for montelukast granules. Which of the following instructions should the nurse provide the client's parent on administering the medication?

Theophylline is a bronchodilator medication used in the treatment of asthma and other respiratory conditions. It works by relaxing the smooth muscles in the airways, allowing for easier breathing. However, theophylline is associated with potential adverse effects, and one of the most significant concerns is its potential to cause dysrhythmias (irregular heart rhythms).

Dysrhythmias can include tachycardia (rapid heart rate), atrial fibrillation, or other disturbances in heart rhythm.

Constipation is not a commonly reported adverse effect of theophylline. Oliguria (decreased urine output) is not typically associated with theophylline use. Drowsiness can occur with theophylline, but dysrhythmias are considered a more significant and potentially serious adverse effect. It is crucial for the nurse to educate the client about the potential for dysrhythmias and advise them to report any irregular heartbeat or other cardiac symptoms promptly.

White coating in the mouth: A white coating in the mouth could be a sign of a fungal infection such as oral thrush. Fluticasone, which is a corticosteroid, can increase the risk of developing fungal infections. Therefore, the nurse should instruct the client to report any signs of oral thrush or other unusual changes in the mouth, such as white patches or discomfort, to the provider.
Prompt identification and treatment of oral thrush are necessary to prevent its progression and ensure effective management of the client's condition.
Dry oral mucous membranes: Dry oral mucous membranes are not typically associated with fluticasone/salmeterol use. However, if the client experiences persistent or severe dryness in the mouth or any other unusual oral symptoms, it should be reported to the provider. Dry mouth can sometimes occur as a side effect of medications or indicate other underlying issues that need to be addressed.
Sedation: Sedation is not a common side effect of fluticasone/salmeterol. If the client experiences excessive drowsiness or sedation that interferes with their daily activities, it may be important to report this to the provider. While sedation is not a typical adverse effect of this medication, individual responses can vary, and it is essential to ensure appropriate monitoring and management.
Increased appetite is not typically associated with fluticasone/salmeterol use. It is not a commonly reported adverse effect of the medication. However, if the client experiences significant and unexplained changes in appetite that are concerning or persistent, it may be worth mentioning to the provider during a follow-up appointment or as part of ongoing monitoring.