A nurse is providing education to a client who has chronic obstructive pulmonary disease and will begin using fluticasone by metered dose inhaler every 12 hours for maintenance. Which of the following instructions should the nurse include?
"Use this inhaler as the first-line medication to relieve acute symptoms."
"Inspect your mouth daily for signs of thrush."
"Check your heart rate before each dose."
"Skip the morning dose if you do not have any symptoms."
The Correct Answer is B
A. Fluticasone is a corticosteroid inhaler used for maintenance therapy to reduce inflammation in the airways over time. It is not a rescue medication for acute symptoms. Clients with COPD should use short-acting bronchodilators (such as albuterol) as their first-line treatment for relieving acute symptoms like shortness of breath or wheezing.
B. This statement is correct. Fluticasone is a corticosteroid medication that, when inhaled, can increase the risk of developing oral candidiasis (thrush). Clients should be instructed to rinse their mouth with water and spit after using the inhaler to minimize this risk. Inspecting the mouth daily for signs of white patches, soreness, or difficulty swallowing is important. If thrush develops, clients may need antifungal treatment.
C. This statement is not necessary for fluticasone inhaler use. Fluticasone is not known to significantly affect heart rate. Monitoring heart rate before each dose is more relevant for medications that can cause changes in heart rate, such as bronchodilators (e.g., beta-agonists). However, clients should monitor for symptoms like palpitations or rapid heart rate and report them to their healthcare provider.
D. Fluticasone is a maintenance medication that should be taken regularly as prescribed, regardless of symptoms. Skipping doses can lead to worsening of COPD symptoms and exacerbations. Clients should adhere to the prescribed dosing schedule to achieve optimal control of their condition.
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Related Questions
Correct Answer is C
Explanation
A. Most individuals with Bell's palsy experience gradual improvement within weeks to months, and the majority recover completely. Permanent facial paralysis is rare, but some individuals may have residual mild weakness or asymmetry.
B. This statement is not typically true for Bell's palsy. Antibiotic eye drops are not routinely prescribed unless there is evidence of corneal exposure due to incomplete eyelid closure (lagophthalmos). Instead, artificial tears and lubricating ointments are often recommended to prevent dryness and protect the cornea.
C. In Bell's palsy, weakness or paralysis of the facial muscles can lead to inability to fully close the eyelid on the affected side. Taping the eyelid closed at night helps prevent corneal damage from exposure and dryness.
D. This statement is not recommended. It is important to avoid stressing the affected facial muscles excessively during recovery from Bell's palsy. Chewing evenly on both sides of the mouth is generally recommended to prevent strain and promote balanced muscle function.
Correct Answer is C
Explanation
A. Medicare does cover individuals under 65 years old who have end-stage renal disease (ESRD) and meet certain criteria.
B. There are programs that allow individuals with both Medicare and low income to qualify for Medicaid, which can help cover additional healthcare costs that Medicare may not fully cover.
C. While Medicare does provide significant coverage for healthcare services, it is not entirely free of out- of-pocket costs. Medicare Part A typically covers hospital stays, skilled nursing facility care, hospice, and some home health care services with no premiums for most people.
D. Medicare is indeed federally-funded health insurance primarily for individuals aged 65 and older. It also covers certain younger individuals with disabilities and those with ESRD.
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