A nurse is caring for a client who develops the rhythm below. The client is unresponsive, pulseless, and apneic. Which of the following actions should the nurse expect to do first?

A) Take the medication with meals:
Inhaled beclomethasone is a corticosteroid, and it is generally not necessary to take it with meals. Oral corticosteroids are sometimes taken with meals to minimize gastric irritation, but this does not apply to inhaled corticosteroids like beclomethasone. The primary concern with inhaled corticosteroids is not related to meal timing but to oral hygiene to prevent side effects like oral thrush.

B) Limit caffeine intake:
There is no direct contraindication or requirement to limit caffeine intake when taking inhaled beclomethasone. While caffeine can have mild bronchodilatory effects, it does not interfere with the action of beclomethasone or exacerbate asthma symptoms. This is not a priority teaching point for the patient.

C) Rinse the mouth after administration:
One of the most important teaching points when using inhaled beclomethasone is to rinse the mouth after each use. This helps to prevent oral thrush (a fungal infection caused by Candida), which is a common side effect of inhaled corticosteroids. Rinsing the mouth with water after administration helps to remove any leftover medication and reduce the risk of infection, making this the most important instruction.

D) Check the pulse before and after medication administration:
While checking the pulse is important for some medications, such as bronchodilators like albuterol, it is not necessary for inhaled beclomethasone. Beclomethasone is a corticosteroid that primarily works by reducing inflammation in the airways, and it does not have a significant impact on heart rate. Therefore, it is not required to monitor pulse before and after its use.

A) Wear a dosimeter badge and lead apron when providing direct patient care: When caring for a patient undergoing internal radiation therapy (brachytherapy), radiation safety is the nurse’s priority. The nurse must take measures to minimize radiation exposure by wearing protective equipment such as a dosimeter badge (to monitor exposure levels) and a lead apron (to shield against radiation). These precautions are critical to protect healthcare workers from potential radiation harm while caring for a patient with a radiation implant.

B) Avoid placing a radiation sign at the entrance of the room for patient privacy: Placing a radiation warning sign at the entrance of the room is a mandatory safety protocol when a patient is undergoing brachytherapy. This warning sign informs healthcare personnel and visitors that radiation is present, and it is important for ensuring safety. Patient privacy should not override radiation safety protocols.

C) Alert family members that they should restrict their visiting to 60 minutes at a time: While it is essential to inform family members about safety precautions when visiting a patient receiving radiation therapy, the priority action for the nurse is to ensure their own safety and radiation exposure first. Limiting family visits is an important step to reduce unnecessary exposure, but this is a secondary concern compared to the nurse's direct radiation safety measures.

D) Explain to the patient that she will continue to emit radiation for months after the implant is removed: The patient will continue emitting radiation only for a short period after the implant is removed. The duration of radiation emission depends on the type of radioactive material used in brachytherapy, but it is typically limited to a few days or weeks at most. In most cases, the nurse would explain to the patient that, after the implant is removed, radiation emission will cease.