A nurse is reinforcing teaching with a client who has angina and a new prescription of nitroglycerin sublingual. Which of the following statements by the client indicates an understanding of the teaching?

A. "Place a thick layer of the medication on open areas." Topical corticosteroids like fluticasone should not be applied in thick layers or to open wounds, as excessive absorption can lead to systemic side effects such as adrenal suppression. A thin layer is sufficient to achieve the desired anti-inflammatory effects while minimizing adverse reactions.

B. “Rub the medication until it disappears.” Topical corticosteroids should be applied in a thin layer and gently rubbed into the skin until no visible residue remains. This ensures even absorption without excessive medication buildup, reducing the risk of local and systemic side effects, especially in infants who have a higher risk of absorption due to their thinner skin.

C. "Cover the area with an occlusive dressing." Occlusive dressings increase medication absorption, which can lead to systemic corticosteroid effects such as skin thinning, delayed wound healing, and adrenal suppression. Occlusion should only be used under medical supervision, especially in infants who are more susceptible to these effects.

D. "Apply the medication to your infant's entire arm." Fluticasone should be applied only to affected areas, not the entire limb. Applying it over a larger area than necessary increases the risk of systemic absorption and side effects. The medication should be used only as directed for targeted treatment of atopic dermatitis.

A. Premedicate the client with diphenhydramine. Premedicating with diphenhydramine is not necessary unless the client has a history of mild allergic reactions to erythromycin. Erythromycin is a macrolide antibiotic and does not have significant cross-reactivity with penicillin, making premedication unnecessary.

B. Request a different route of administration from the provider. Changing the route of administration does not address concerns about allergy. Erythromycin is well tolerated in clients with a penicillin allergy, and there is no indication that a different route would be required unless the client has difficulty swallowing or gastrointestinal intolerance.

C. Administer the medication to the client. Erythromycin belongs to the macrolide class and is commonly prescribed as an alternative for clients allergic to penicillin. There is no cross-reactivity between macrolides and penicillins, making erythromycin a safe and effective option for treating bacterial infections in these clients.

D. Request a different medication from the provider. There is no need to request an alternative medication unless the client has a known allergy to erythromycin. Since macrolides are safe for clients with penicillin allergies, withholding the medication without a valid reason could delay necessary treatment.