A nurse is providing discharge teaching to the parent of a child who has a prescription for fluticasone metered-dose inhaler. Which of the following statements should the nurse include in the teaching?

Choice A reason: Crushing divalproex sodium capsules is contraindicated because it alters the pharmacological integrity of the medication. Crushing can destroy the extended-release properties, leading to rapid absorption and increased risk of toxicity. This makes the option unsafe.

Choice B reason: Placing the medication under the tongue is inappropriate because divalproex sodium is not formulated for sublingual administration. Sublingual placement would not provide proper absorption and could irritate mucous membranes.

Choice C reason: Chewing the medication before swallowing is incorrect because it disrupts the capsule’s design, leading to altered absorption and potential gastrointestinal irritation. Chewing can also cause a bitter taste and reduce compliance.

Choice D reason: Administering sprinkle capsules with applesauce is the correct action. The capsule contents can be sprinkled onto soft food like applesauce, which facilitates swallowing in clients with dysphagia while maintaining the medication’s integrity. This method ensures proper absorption and safety, making it the best choice.

Choice A reason: Bronchodilators are used for conditions such as asthma or COPD to relieve bronchospasm. They are not routinely indicated for end-of-life dyspnea unless the client has a specific underlying respiratory condition. This option is incorrect because it does not address typical palliative care measures.

Choice B reason: Placing the client in Trendelenburg position (head lower than feet) worsens breathing difficulty by increasing pressure on the diaphragm and promoting aspiration risk. This option is incorrect because it would exacerbate respiratory distress.

Choice C reason: Using a fan to increase air circulation is a simple, non-invasive, and effective intervention for relieving dyspnea at the end of life. The sensation of moving air across the face can reduce the perception of breathlessness and improve comfort. This is the correct answer because it aligns with evidence-based palliative care practices.

Choice D reason: Decreasing oral fluid intake does not relieve dyspnea. While fluid restriction may be used in cases of fluid overload, it is not a direct intervention for easing breathing difficulty in end-of-life care. This option is incorrect because it does not address the client’s immediate symptom.