A nurse is providing discharge teaching to a client who has asthma and a new prescription for ﬂuticasone/salmeterol. For which of the following adverse eﬀects should the nurse instruct the client to report to the provider?

Dry oral mucous membranes

White coating in the mouth

Sedation

Increased appetite

Answer and Explanation

The Correct Answer is B

White coating in the mouth, also known as oral candidiasis or thrush, is a serious adverse eﬀect of ﬂuticasone/salmeterol, which is a combination of an inhaled corticosteroid and a long-acting beta2 agonist. It is caused by fungal infection of the oral cavity due to suppression of the normal ﬂora by the corticosteroid component. The client should report this symptom to the provider, as it may require antifungal treatment and discontinuation of the medication.

a) Dry oral mucous membranes is a common and mild adverse eﬀect of ﬂuticasone/salmeterol, which can be relieved by drinking water, chewing sugarless gum, or using artificial saliva. It does not require reporting to the provider or stopping the medication.
c) Sedation is not an adverse eﬀect of ﬂuticasone/salmeterol, but it may be caused by other medications, such as antihistamines, opioids, or benzodiazepines. The client should avoid driving or operating machinery if sedated and consult with the provider about possible drug interactions.
d) Increased appetite is not an adverse eﬀect of ﬂuticasone/salmeterol, but it may be caused by other factors, such as stress, boredom, or hormonal changes. The client should maintain a balanced diet and exercise regularly to prevent weight gain and promote health.

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Correct Answer is A

Explanation

Using a bronchodilator 1 hour before eating can help reduce dyspnea and improve appetite for a client who has COPD. It can also facilitate oxygen delivery to the tissues and prevent hypoxia.

b) Eating 3 large meals each day is not recommended for a client who has COPD, as it can cause abdominal distension and increase pressure on the diaphragm, leading to dyspnea and fatigue. A better option is to eat 5 to 6 small meals throughout the day.
c) Limiting water intake with meals is not advisable for a client who has COPD, as it can cause dehydration and increase the viscosity of secretions, making them harder to expectorate. A better option is to drink at least 2 L of ﬂuids per day, preferably between meals.
d) Reducing protein intake is not beneficial for a client who has COPD, as protein is essential for maintaining muscle mass and strength, especially of the respiratory muscles. A better option is to increase protein intake to at least 1.2 g/kg of body weight per day.

A. Observe for signs of infection B. Examine the skin for generalized urticaria C. Review laboratory test results for low hemoglobin D. Monitor the mouth for signs of xerostomia

Correct Answer is A

Explanation

Radiation therapy can cause immunosuppression, which increases the risk of infection. The nurse should monitor the client for signs of infection such as fever, chills, malaise, or purulent drainage.

Examine the skin for generalized urticaria. This is not a common side eﬀect of radiation therapy, as urticaria is an allergic reaction that causes hives or welts on the skin. Radiation therapy can cause localized skin irritation, erythema, or dryness, but not generalized urticaria.
Review laboratory test results for low hemoglobin. This is not a direct eﬀect of radiation therapy, as hemoglobin is a component of red blood cells that carries oxygen in the blood. Radiation therapy can cause anemia, which is a low number of red blood cells, but not necessarily low hemoglobin.
Monitor the mouth for signs of xerostomia. This is not relevant for a client who receives radiation therapy to treat lung cancer, as xerostomia is dry mouth caused by reduced salivary gland function. This can occur in clients who receive radiation therapy to treat head and neck cancer, but not lung cancer.

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A nurse is providing discharge teaching to a client who has asthma and a new prescription for ﬂuticasone/salmeterol. For which of the following adverse eﬀects should the nurse instruct the client to report to the provider?

Nursing Test Bank

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Correct Answer is A

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