A nurse is reviewing the medical record of a client who reports taking pseudoephedrine for sinus congestion as needed. The nurse should identify that pseudoephedrine is contraindicated for which of the following client conditions?

Leukotriene receptor antagonists (LTRAs) like Montelukast are commonly used in the treatment of asthma. They work by blocking the action of leukotrienes, which are inflammatory substances that can cause narrowing and inflammation of the airways in individuals with asthma. By preventing this inflammation, LTRAs help to reduce asthma symptoms and prevent asthma attacks.

The other options mentioned in the statements are not accurate or appropriate for teaching about Montelukast. Taking the medication only when experiencing symptoms is not the recommended approach, as LTRAs are typically taken regularly as part of ongoing asthma management. The statement about the therapeutic effect taking several weeks to notice is not accurate, as Montelukast can start to provide symptom relief within a shorter timeframe.

Additionally, the statement about increasing fiber and fluid intake to prevent constipation is unrelated to the use of Montelukast and may not apply to this medication specifically.

White coating in the mouth: A white coating in the mouth could be a sign of a fungal infection such as oral thrush. Fluticasone, which is a corticosteroid, can increase the risk of developing fungal infections. Therefore, the nurse should instruct the client to report any signs of oral thrush or other unusual changes in the mouth, such as white patches or discomfort, to the provider.
Prompt identification and treatment of oral thrush are necessary to prevent its progression and ensure effective management of the client's condition.
Dry oral mucous membranes: Dry oral mucous membranes are not typically associated with fluticasone/salmeterol use. However, if the client experiences persistent or severe dryness in the mouth or any other unusual oral symptoms, it should be reported to the provider. Dry mouth can sometimes occur as a side effect of medications or indicate other underlying issues that need to be addressed.
Sedation: Sedation is not a common side effect of fluticasone/salmeterol. If the client experiences excessive drowsiness or sedation that interferes with their daily activities, it may be important to report this to the provider. While sedation is not a typical adverse effect of this medication, individual responses can vary, and it is essential to ensure appropriate monitoring and management.
Increased appetite is not typically associated with fluticasone/salmeterol use. It is not a commonly reported adverse effect of the medication. However, if the client experiences significant and unexplained changes in appetite that are concerning or persistent, it may be worth mentioning to the provider during a follow-up appointment or as part of ongoing monitoring.