A nurse is planning to change the dressings on a school-age child who has sustained multiple burns. Which of the following actions should the nurse plan to take?

A. A client who has a forehead wound that is bleeding copiously. Although bleeding may appear dramatic, most scalp wounds bleed heavily and can be controlled with pressure. This is not immediately life-threatening if the client is stable.
B. A client who has a compound fracture of the femur and is crying in pain. This is a serious injury with risk for blood loss and infection, but the client is alert and stable enough to express pain, suggesting less immediate neurologic risk than other clients.
C. A client who was unconscious at the scene and now reports diplopia and nausea. This client likely has a head injury with signs of increased intracranial pressure or concussion (diplopia = double vision, nausea, and prior loss of consciousness). These are neurological red flags and require immediate evaluation to prevent deterioration.
D. A client who has several missing teeth and a swollen, ecchymotic upper lip. While painful and concerning, oral trauma without airway compromise is less urgent than potential brain injury.

A. "Administer this medication as needed for symptom control." Fluticasone is an inhaled corticosteroid used for long-term control, not for acute symptom relief. It should be administered on a regular schedule, not as needed.
B. "Rinse mouth and gargle with water after each use." Rinsing the mouth helps prevent oral thrush (candidiasis), a common side effect of inhaled corticosteroids like fluticasone. It reduces residual medication in the mouth and supports good oral hygiene.
C. “Administer this medication before any other inhaled medications.” Fluticasone should be given after bronchodilators, such as albuterol, if both are prescribed. Administering a bronchodilator first opens the airways and allows the corticosteroid to work more effectively.
D. "Growth may be accelerated while using this medication?” Inhaled corticosteroids may cause slowed growth in some children with long-term use, though the effect is generally small and outweighed by the benefits of asthma control.