When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client’s upper back and the client denies pain. Which action should the nurse take?

Choice A reason: Omeprazole is a proton pump inhibitor used to treat gastroesophageal reflux disease (GERD). While it is generally safe, it is not commonly associated with causing jaundice. Omeprazole can cause liver enzyme elevations in rare cases, but it is not a primary concern for drug-induced jaundice.

Choice B reason: Acetaminophen is known to cause hepatotoxicity, especially in high doses or with prolonged use. It is one of the most common causes of drug-induced liver injury, which can lead to jaundice. The nurse should notify the healthcare provider about the use of acetaminophen, as it is a likely culprit for the client’s jaundice.

Choice C reason: Captopril is an ACE inhibitor used to treat hypertension. While it can cause various side effects, it is not typically associated with causing jaundice. The primary concerns with captopril are related to renal function and electrolyte imbalances.

Choice D reason: Prednisone is a corticosteroid used to reduce inflammation in conditions like osteoarthritis. Although long-term use of corticosteroids can affect liver function, it is not commonly associated with causing jaundice. The nurse should still monitor liver function but focus on more likely causes.

Choice A reason:

Rinsing the mouth after each use of an inhaler is a recommended practice, especially for inhalers containing corticosteroids, to prevent oral thrush and other side effects. Although ipratropium is not a corticosteroid, rinsing the mouth can still help reduce any potential irritation or unpleasant taste.

Choice B reason:

Storing the medication at room temperature is appropriate for most inhalers, including ipratropium2. This ensures the medication remains effective and safe to use. It is important to keep the inhaler away from extreme temperatures and direct sunlight.

Choice C reason:

Attaching a spacer device to the inhaler can be beneficial, especially for patients who have difficulty coordinating the timing of inhalation with the activation of the inhaler. A spacer helps ensure that more medication reaches the lungs rather than being deposited in the mouth or throat.

Choice D reason:

Priming the inhaler with 7 pumps is excessive. Typically, ipratropium inhalers require priming with only 2 to 4 sprays before the first use or if the inhaler has not been used for a few days. Over-priming can waste medication and may indicate that the client needs additional instruction on proper inhaler use.