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?

"Administer this medication as needed for symptom control.”

"Rinse mouth and gargle with water after each use."

“Administer this medication before any other inhaled medications.”

"Growth may be accelerated while using this medication?”

Answer and Explanation

The Correct Answer is B

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.

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Correct Answer is A

Explanation

A. Provide a verbal report of the client's condition to the paramedic performing the transfer. This is an appropriate and secure method for communicating essential health information directly involved in the client’s care. It ensures continuity of care while maintaining confidentiality.
B. Email the client's health information to the facility in an unencrypted file. Sending health information via unencrypted email violates HIPAA guidelines and poses a risk to client confidentiality due to potential unauthorized access.
C. Discuss the client's response to the transfer with another staff nurse. Unless the staff nurse is directly involved in the client’s care, this would be a breach of confidentiality. Personal health information should only be shared on a need-to-know basis.
D. Fax the client's name and identifiable information to the rehabilitation facility. Faxing is permissible only when appropriate safeguards are in place. However, faxing identifiable information without confirming the recipient or using secure protocols can risk a confidentiality breach.

A. Decrease the maintenance infusion rate of IV fluid. B. Have protamine sulfate available at the bedside. C. Reposition the client side-to-side each hour. D. Monitor the client for hypertension

Correct Answer is C

Explanation

A. Decrease the maintenance infusion rate of IV fluid. Epidural anesthesia can cause hypotension, so IV fluids are often used to help maintain blood pressure. Reducing the fluid rate may increase the risk of hypotensive episodes.
B. Have protamine sulfate available at the bedside. Protamine sulfate is the antidote for heparin, not relevant to epidural anesthesia. It is not required in the management of epidural-related side effects.
C. Reposition the client side-to-side each hour. Frequent repositioning helps prevent pressure injuries, promotes fetal oxygenation, and encourages effective labor progression. It also aids in the distribution of the anesthetic agent.
D. Monitor the client for hypertension. Hypotension, not hypertension, is a common adverse effect of epidural anesthesia due to vasodilation and decreased peripheral resistance. Blood pressure should be monitored closely for drops.

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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?

Nursing Test Bank

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