To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client’s caregivers?

 

Choice A Reason:

Inquiring about perceived anxiety is important because anxiety can contribute to sleep difficulties. However, in the context of a client taking dextroamphetamine-amphetamine, the timing of the medication is more directly related to sleep disturbances. While anxiety should be assessed, it is not the most critical factor in this scenario.

Choice B Reason:

Determining what time the dose is taken is crucial because dextroamphetamine-amphetamine is a stimulant that can interfere with sleep if taken too late in the day. Extended-release formulations are designed to provide a steady release of medication throughout the day, but taking the dose too late can lead to insomnia. Adjusting the timing of the dose can help mitigate sleep disturbances.

Choice C Reason:

Determining daily caffeine intake is relevant because caffeine is a stimulant that can also contribute to sleep difficulties. However, the primary concern in this scenario is the timing of the dextroamphetamine-amphetamine dose. While caffeine intake should be assessed, it is secondary to the medication timing.

Choice D Reason:

Asking about the client’s bedtime routine is important for understanding overall sleep hygiene. Good sleep hygiene practices can help improve sleep quality. However, in this context, the timing of the stimulant medication is more directly related to the reported sleep difficulties. Therefore, while bedtime routine is important, it is not the most critical assessment.

Choice A Reason:

Checking for the correct placement of the patch behind the client’s ear is important to ensure proper administration of the medication. However, this action does not address the client’s concern about pain relief. Scopolamine is used to prevent nausea and vomiting, not to manage pain. Therefore, while correct placement is necessary, it does not explain why the client is still experiencing pain.

Choice B Reason:

Offering to apply a new transdermal patch to relieve the pain is not appropriate because scopolamine is not intended for pain relief. Applying a new patch would not address the client’s pain and could lead to unnecessary medication use. The nurse should clarify the purpose of the medication instead.

Choice C Reason:

Explaining that the medication is not given to prevent pain is the correct action. Scopolamine is an anticholinergic medication used to prevent nausea and vomiting associated with motion sickness and recovery from anesthesia. It is not an analgesic and does not provide pain relief. The nurse should inform the client about the intended use of the medication and address pain management separately.

Choice D Reason:

Advising the client that the effects of the medication have worn off is incorrect. Scopolamine patches are designed to release medication over a period of up to 72 hours. The effects would not wear off within a few hours. This statement does not address the client’s misunderstanding about the purpose of the medication.