A nurse is reinforcing discharge teaching with client who has stable angina pectoris. Which of the following statements by the client indicates an understanding of what to do when chest pain occurs?

A) "It takes 2 months of scheduled use before this medication is effective.":
This statement is incorrect. Montelukast is a leukotriene receptor antagonist that works to prevent asthma symptoms and improve lung function. It typically takes a few days to a week for the medication to become effective, not 2 months. Immediate relief is not expected, but long-term benefits can be seen within a relatively short period after starting the medication.

B) "I will give this medication to my child every 2 hours if he is wheezing.":
This statement is incorrect. Montelukast is a maintenance medication that is taken on a daily basis to prevent asthma symptoms. It is not a rescue medication and should not be used every 2 hours when the child is wheezing. Rescue medications like short-acting beta-agonists (e.g., albuterol) should be used during an asthma attack or when wheezing occurs.

C) "I will give this medication to my child once daily in the evening.":
This statement is correct. Montelukast is typically taken once daily in the evening. It helps to reduce inflammation and prevent asthma symptoms, and taking it in the evening aligns with the medication's intended use for long-term control of asthma.

D) "I can stop giving my child this medication if he is taking steroids.":
This statement is incorrect. Montelukast is often used alongside steroids (inhaled corticosteroids) for managing asthma. The two medications work in different ways, and discontinuing montelukast while continuing steroids may not provide optimal asthma control. It is important to follow the healthcare provider's instructions regarding the use of both medications.

A) Administer granulocyte colony stimulating factor: Granulocyte colony-stimulating factor (G-CSF) is used to stimulate white blood cell production in certain conditions like neutropenia. However, in an infant with HIV, the primary concern is the HIV progression and monitoring for complications rather than administering G-CSF. It is not routinely used for infants with HIV unless there is a specific indication such as neutropenia.

B) Monitor the infant's lymphocyte count: Monitoring the infant’s lymphocyte count is an appropriate and essential intervention. HIV affects the immune system by targeting CD4+ T lymphocytes, so tracking the lymphocyte count will help gauge the progression of the disease and the effectiveness of the treatment. It is vital to assess the infant’s immune status, as HIV can lead to a weakened immune system and increase susceptibility to infections.

C) Initiate droplet precautions: Droplet precautions are typically required for infections like influenza or certain respiratory illnesses. HIV is not transmitted via droplets; it is primarily transmitted through blood, sexual contact, and from mother to child during childbirth or breastfeeding. Therefore, droplet precautions are not necessary for this infant.

D) Educate the infant's guardians about exchange transfusions: Exchange transfusions are generally not a routine intervention for infants with HIV unless there is a specific complication like severe hyperbilirubinemia or other hematologic conditions. The focus for infants with HIV is on managing antiretroviral therapy (ART) and preventing infections, rather than performing exchange transfusions. Educating the guardians about ART and infection prevention would be more appropriate.