A nurse is providing discharge instructions to a client who has asthma and is about to start taking theophylline (Theo-24). The nurse should tell the client that this medication might cause which of the following adverse effects?

When using an albuterol inhaler, it is important for the client to take a slow and deep inhalation while releasing the medication from the inhaler. After inhaling the medication, holding the breath for about 10 seconds allows the medication to reach deep into the airways and maximize its effectiveness.

The other actions mentioned are not correct:
A. Waiting 10 minutes between inhalations: Albuterol inhalers are typically used as a quick-relief medication for acute symptoms, and waiting 10 minutes between inhalations may not provide immediate relief when needed. The specific instructions on the frequency of inhalations should be provided by the healthcare provider.

B. Taking a quick inhalation while releasing the medication from the inhaler: It is important to take a slow and deep inhalation while releasing the medication to ensure that the medication reaches the lungs effectively. Taking a quick inhalation may result in less effective delivery of the medication.

D. Exhaling as the medication is released from the inhaler: It is important to exhale fully before using the inhaler to ensure that the medication is inhaled deeply into the lungs. Exhaling while releasing the medication can interfere with the proper inhalation technique.

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.