A nurse on an oncology unit is caring for a client who is receiving intravenous chemotherapy for the treatment of advanced colon cancer. Which of the following items should be included in the plan of care for this client?

A. Fluticasone is an inhaled corticosteroid used primarily for maintenance therapy in COPD and asthma. It helps reduce airway inflammation and prevent exacerbations but is not used for immediate relief of acute symptoms such as bronchospasm or sudden shortness of breath.
B. Fluticasone, like other corticosteroids delivered by inhalation, can increase the risk of oral thrush (candidiasis) due to its local immunosuppressive effects in the mouth. It's important for clients to monitor their oral cavity regularly for signs such as white patches or soreness. Including this instruction is crucial to detect thrush early so that appropriate treatment can be initiated if necessary.
C. Monitoring heart rate is not specifically necessary before each dose of fluticasone. Fluticasone is not known to cause significant cardiovascular effects such as changes in heart rate. Heart rate monitoring may be more relevant for medications that can affect cardiovascular function or in clients with pre- existing cardiac conditions.

D. Fluticasone should be used regularly as prescribed for maintenance therapy to control airway inflammation and prevent exacerbations in COPD. Skipping doses, even if symptoms are not present, can lead to inadequate control of the disease and potential worsening of symptoms over time.

A. Plasmapheresis, also known as plasma exchange, is a treatment where blood plasma containing harmful antibodies is removed from the blood and replaced with donor plasma or albumin. This procedure is effective in reducing the severity and duration of symptoms in GBS by removing the antibodies that attack the peripheral nerves. Plasmapheresis is typically recommended within the first 2 weeks of symptom onset to maximize its benefits.
B. Riluzole is a medication that modulates glutamate neurotransmission and is primarily used in the treatment of amyotrophic lateral sclerosis (ALS). While some studies have explored its potential use in GBS, its efficacy in GBS treatment remains uncertain and it is not considered a standard treatment.
C. Anticholinesterase agents, such as pyridostigmine, are used in conditions characterized by neuromuscular junction dysfunction, such as myasthenia gravis. However, in GBS, where the primary pathology is the demyelination of peripheral nerves rather than neuromuscular junction dysfunction, anticholinesterase agents are not effective and can potentially worsen symptoms.
D. Acyclovir is an antiviral medication primarily used to treat infections caused by herpesviruses, including herpes simplex virus (HSV) and varicella-zoster virus (VZV). It has no role in the treatment of GBS because GBS is not caused by viral infections.