A nurse is reinforcing discharge teaching with the parents of an infant who has a prescription for home oxygen and pulse oximetry monitoring. Which of the following statements by the parents indicates a need for further teaching?

Choice A reason: Shaking the inhaler well before using it is a correct action for the client to take, as it helps to mix the medication and the propellant. However, it is not the best answer, as it is a general instruction that applies to most inhalers, not a specific one that indicates an understanding of the teaching.

Choice B reason: Holding the breath for 10 seconds after inhaling the medication is a correct action for the client to take, as it helps to keep the medication in the lungs and improve its absorption. However, it is not the best answer, as it is a general instruction that applies to most inhalers, not a specific one that indicates an understanding of the teaching.

Choice C reason: Rinsing the mouth with water after using the inhaler is the best answer, as it indicates an understanding of the teaching. Rinsing the mouth with water helps to prevent oral thrush, a fungal infection that can occur as a side effect of some inhalers, especially those that contain steroids.

Choice D reason: Waiting 30 seconds between each puff of the inhaler is not a correct action for the client to take, as it can reduce the effectiveness of the medication. The client should wait at least one minute between each puff of the inhaler, unless instructed otherwise by the provider.

Choice A reason: Crackles auscultated over the client's lung fields are not a sign of pleural effusion. Crackles are abnormal breath sounds that indicate fluid or secretions in the alveoli. They can be heard in conditions such as pneumonia, heart failure, or pulmonary edema.

Choice B reason: Crepitus palpated on the client's chest is not a sign of pleural effusion. Crepitus is a crackling sensation that occurs when air leaks into the subcutaneous tissue. It can be felt in conditions such as pneumothorax, chest trauma, or chest surgery.

Choice C reason: Substernal retractions noted on the client's chest are not a sign of pleural effusion. Substernal retractions are inward movements of the chest wall below the sternum that indicate increased respiratory effort. They can be seen in conditions such as asthma, bronchiolitis, or croup.

Choice D reason: Dullness percussed over the client's lung fields is a sign of pleural effusion. Dullness is a flat sound that indicates the presence of a solid or liquid mass in the thoracic cavity. It can be detected in conditions such as pleural effusion, atelectasis, or consolidation.