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This response demonstrates that the patient understands the dosing frequency (twice a day) and the importance of taking it with a full glass of water, which aligns with the instructions provided by the nurse.

Nasal glucocorticoids, also known as intranasal corticosteroids, are considered the most effective and recommended first-line treatment for nasal congestion caused by allergic rhinitis or non-allergic rhinitis. They work by reducing inflammation in the nasal passages, relieving congestion, and improving other symptoms such as itching, sneezing, and runny nose.

The sympathetic nervous system postganglionic neurons primarily release norepinephrine as their neurotransmitter. These neurons are part of the autonomic nervous system and are responsible for coordinating the body's "fight or flight" response to stress or danger.

Norepinephrine acts as a neurotransmitter at the postganglionic synapses and binds to adrenergic receptors in the target tissues, mediating the physiological responses associated with sympathetic activation.

While acetylcholine is the primary neurotransmitter released by the preganglionic neurons of the sympathetic nervous system, it is not the neurotransmitter released by postganglionic neurons. Epinephrine (also known as adrenaline) is released into the bloodstream by the adrenal medulla and acts as a hormone, not a neurotransmitter. Arginine is an amino acid and is not directly involved in the neurotransmission of the sympathetic nervous system.

Montelukast is a leukotriene receptor antagonist commonly used to manage asthma and allergic rhinitis. Its primary therapeutic effect is to improve respiratory symptoms by reducing inflammation and constriction of the airways. Therefore, an increased ease of breathing would be an expected outcome indicating that the medication is working effectively.

Expectorants are medications that help thin and loosen mucus in the respiratory tract, making it easier to cough up and clear from the airways. Increasing fluid intake, particularly water helps to keep the mucus thin and less sticky, facilitating its removal. Adequate hydration can help promote effective expectoration and relieve congestion.

During an acute asthma attack, the airways become narrowed and inflamed, leading to symptoms such as wheezing, shortness of breath, and chest tightness. Short-acting beta2 agonists like Albuterol are the first-line medication for relieving acute asthma symptoms. They work by quickly relaxing the smooth muscles in the airways, resulting in bronchodilation and improved airflow. Albuterol provides rapid relief of symptoms and is often administered via inhalation.

"Describe what the pill looks like." This response allows the nurse to gather more information, verify the medication, and ensure that the correct medication is being administered.

Theophylline is a bronchodilator medication used in the treatment of asthma and other respiratory conditions. It works by relaxing the smooth muscles in the airways, allowing for easier breathing. However, theophylline is associated with potential adverse effects, and one of the most significant concerns is its potential to cause dysrhythmias (irregular heart rhythms).

Dysrhythmias can include tachycardia (rapid heart rate), atrial fibrillation, or other disturbances in heart rhythm.

Constipation is not a commonly reported adverse effect of theophylline. Oliguria (decreased urine output) is not typically associated with theophylline use. Drowsiness can occur with theophylline, but dysrhythmias are considered a more significant and potentially serious adverse effect. It is crucial for the nurse to educate the client about the potential for dysrhythmias and advise them to report any irregular heartbeat or other cardiac symptoms promptly.

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.