A nurse is preparing an in-service for an annual skills fair at a community medical facility about fire safety. Place the steps in the order in which they should be performed in the case of a fire emergency. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)

A. Take the medication with meals: Beclomethasone is an inhaled corticosteroid used to prevent asthma symptoms. It should be taken as prescribed by the healthcare provider, usually inhaled at specific times each day. Taking the medication with meals is not necessary, as it does not affect its efficacy or absorption.
B. Check the pulse after medication administration: Checking the pulse is not typically indicated after administering inhaled beclomethasone. Beclomethasone is a corticosteroid inhaler used for long-term control of asthma symptoms and is not associated with significant cardiovascular effects that would necessitate pulse monitoring.
C. Limit caffeine intake: Limiting caffeine intake is not specifically related to the administration of inhaled beclomethasone. However, caffeine can exacerbate some asthma symptoms in susceptible individuals, so general advice to limit caffeine intake may be beneficial for managing asthma symptoms overall. Still, it's not directly related to the administration of this medication.
D. Rinse the mouth after administration: This is the correct action. Inhaled corticosteroids like beclomethasone can cause local side effects such as oral candidiasis (thrush) or dysphonia (hoarseness) due to deposition of the medication in the mouth and throat. Rinsing the mouth with water after each dose helps minimize these side effects by reducing the amount of medication left in the mouth, thereby decreasing the risk of oral candidiasis and other local adverse effects.

A. Divalproex: Divalproex is typically administered with food to minimize gastrointestinal side effects and enhance absorption. Administering it after breakfast or with a meal is recommended to reduce the risk of stomach upset and improve its bioavailability. Taking divalproex with food also helps to slow its absorption, which can decrease the incidence of adverse effects such as nausea and vomiting.
B. Mycostatin mouthwash: Mycostatin mouthwash is a topical antifungal medication used to treat oral candidiasis. Unlike systemic medications, its efficacy is not significantly influenced by food intake. Therefore, it can be administered before or after meals as prescribed, depending on the convenience of the patient. However, if the patient has oral lesions or discomfort, administering it after meals may be preferable to provide relief and ensure maximum contact time with affected areas.
C. Digoxin: Digoxin is a cardiac glycoside commonly used to treat heart failure and atrial fibrillation. It is typically administered on an empty stomach to facilitate optimal absorption. Giving digoxin before breakfast allows for consistent drug levels and reduces the risk of food interfering with its absorption. By administering it before meals, the nurse ensures that the medication is absorbed efficiently and its therapeutic effects are maximized.
D. Alendronate: Alendronate is a bisphosphonate medication used in the treatment of osteoporosis to prevent bone loss and reduce the risk of fractures. It requires administration on an empty stomach in the morning, usually at least 30 minutes before the first meal or beverage of the day, with a full glass of water. This timing ensures adequate absorption and minimizes the risk of esophageal irritation and ulceration. Alendronate has poor oral bioavailability, and taking it with food, beverages, or medications can significantly decrease its absorption. Therefore, administering it before breakfast on an empty stomach is crucial to optimize its effectiveness and reduce the potential for adverse gastrointestinal effects.