A nurse is caring for a client who is experiencing acute alcohol withdrawal. The nurse should anticipate administering which of the following medications to the client to facilitate the withdrawal process?

A. "Place a thick layer of the medication on open areas." Topical corticosteroids like fluticasone should not be applied in thick layers or to open wounds, as excessive absorption can lead to systemic side effects such as adrenal suppression. A thin layer is sufficient to achieve the desired anti-inflammatory effects while minimizing adverse reactions.

B. “Rub the medication until it disappears.” Topical corticosteroids should be applied in a thin layer and gently rubbed into the skin until no visible residue remains. This ensures even absorption without excessive medication buildup, reducing the risk of local and systemic side effects, especially in infants who have a higher risk of absorption due to their thinner skin.

C. "Cover the area with an occlusive dressing." Occlusive dressings increase medication absorption, which can lead to systemic corticosteroid effects such as skin thinning, delayed wound healing, and adrenal suppression. Occlusion should only be used under medical supervision, especially in infants who are more susceptible to these effects.

D. "Apply the medication to your infant's entire arm." Fluticasone should be applied only to affected areas, not the entire limb. Applying it over a larger area than necessary increases the risk of systemic absorption and side effects. The medication should be used only as directed for targeted treatment of atopic dermatitis.

A. Tinnitus. Nitrofurantoin is not commonly associated with ototoxicity or tinnitus. Medications such as aminoglycosides and loop diuretics are more likely to cause this adverse effect. While nitrofurantoin can have some neurological side effects, tinnitus is not a primary concern.

B. Abdominal cramping. Gastrointestinal side effects such as nausea and vomiting can occur with nitrofurantoin, especially if taken on an empty stomach. However, abdominal cramping is usually mild and not a serious adverse effect requiring discontinuation of the medication. Taking the drug with food can help reduce gastrointestinal discomfort.

C. Stevens-Johnson syndrome. Stevens-Johnson syndrome (SJS) is a rare but serious hypersensitivity reaction that can occur with nitrofurantoin use. It presents with flu-like symptoms, followed by a painful rash, blistering, and skin peeling. Immediate discontinuation and medical intervention are required if symptoms develop, as SJS can be life-threatening.

D. Insomnia. Nitrofurantoin does not commonly cause insomnia. Some medications, such as corticosteroids and stimulants, are more likely to interfere with sleep. Nitrofurantoin’s side effects primarily affect the gastrointestinal, pulmonary, and dermatologic systems rather than sleep patterns.